Vestibular Migraine, How Accurately Can It Be Diagnosed? Prevalence of Preliminary Clinical Diagnosis at a Dizziness Clinic and Prevalence Based on Bárány and Neuhauser Diagnostic Criteria

Abstract

Background and Objectives Vestibular migraine (VM) is considered to be one of the most common causes of episodic vertigo. The diagnosis for VM must be confirmed by a complex set of diagnostic criteria set by the Bárány Society (BS) which includes the definition of vestibular symptoms, number, intensity, and duration of dizziness, a history of migraine according to the International Classification of Headache Disorders, 3rd edition, and the co-occurrence of vertigo and migraine. Should all these conditions be met, the actual prevalence evaluated at a clinic would be much lower than previously known or estimated. In this study, we aimed to compare the prevalence of VM based on different diagnostic criteria, the BS criteria and the previous Neuhauser criteria. They were compared with the prevalence of the preliminary clinical diagnosis during an outpatient visit.Subjects and Method The medical records of new patients who presented dizziness who at the clinic from December 2018 to November 2020 were reviewed. The patients completed a questionnaire designed to identify VM according to the BS criteria. Cases meeting the BS or Neuhauser criteria and those described as VM in the clinical impression of the medical records were identified.Results During the study period, 955 patients presented complaining of dizziness to the otolaryngology department. Among those patients, 11.6% were given preliminary clinical diagnosis of VM in the outpatient clinic. However, only 2.9% were diagnosed with VM using the BS criteria, and the prevalence was 9.3% using the Neuhauser’s criteria.Conclusion The prevalence of VM using the BS criteria was much lower than the prevalence of preliminary clinical diagnoses in outpatient clinics or using the previously used Neuhauser criteria.