Abstract
BackgroundThere is evidence suggesting that migraine may be associated with vertigo. The aim of this study was to assess the risk of benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, in patients with migraine using a population-based dataset.MethodsThe National Health Insurance Research Database in Taiwan was searched for migraine patients and was also used to select an age- and sex-matched cohort of subjects without migraine. The analyses included 8266 migraine patients and 8266 controls. The incidence rates of BPPV in the two cohorts were compared. Cox proportional hazard models were used to identify risk factors for BPPV in migraine patients.ResultsIn the migraine cohort, 1.11 % of the patients developed BPPV compared to 0.5 % of the controls. The incidence rate ratio was 2.03 (95 % CI 1.41–2.97; p <0.001). Cox proportional hazards analysis showed that age ≥40 years (HR 2.20; 95 % CI 1.40–3.45; p = 0.001), coronary artery disease (HR 4.62; 95 % CI 1.12–19.01; p = 0.034), and the number of outpatient department visits to neurologists because of migraine (HR 2.93; 95 % CI 2.50–3.44; p >0.001) were associated with an increased risk for BPPV.ConclusionThe results showed that patients with migraine had a 2.03-fold increased risk of developing BPPV compared with age- and sex-matched controls. Although BPPV may not be a common condition in migraine patients, migraine sufferers with vestibular symptoms should alert physicians to the possibility of BPPV, particularly if patients are aged ≥40 years, have a history of coronary artery disease, or have frequent visits to neurologists clinics because of migraine.
Highlights
There is evidence suggesting that migraine may be associated with vertigo
Demographic characteristics of the study population During the 10-year study period, a total of 14,164 migraine patients were diagnosed or had diagnoses confirmed by neurologists
After excluding patients with aged < 20 (n = 1,255) or ≥ 65 years (n = 1,304), benign paroxysmal positional vertigo (BPPV) before migraine diagnosis (n = 65), acoustic neuroma (n = 21), Meniere’s disease (n = 789), vestibular neuritis (n = 372), labyrinthitis (n = 38), sudden hearing loss (n = 35), and head injury (n = 2,019) diagnosed at any time within the study period, the final sample consisted of 8266 patients for the analyses
Summary
There is evidence suggesting that migraine may be associated with vertigo. The aim of this study was to assess the risk of benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, in patients with migraine using a population-based dataset. Both migraine and vertigo rank among the most common complaints in the general population. A Kayan and Hood reported that migraine patients had a much higher incidence of vertigo than the tension headache patients (26.5 % versus 7.8 %) [2]. An epidemiological study had reported that there might be a link between migraine and vertigo [3]. People between the ages of 25 and 55, usually the most productive years of life, have the highest prevalence of migraine [5]
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