Videonystagmography (VNG) and video head impulse test (vHIT) analysis of patients with migraine who had first episode of vertigo

Abstract

Objective This study reviews the pattern of vestibular disturbance by videonystagmography (VNG) and video head impulse (vHIT) tests in patients with migraine during first attack of vertigo. Method Thirty-four patients with migraine (21 female, 13 male) were recruited. The main outcome measure is to analyze the spontaneous nystagmus, VNG findings, and the pattern of vHIT abnormality. Patients were grouped as those with (Group-I, 24 patients) or without (Group-II, 10 patients) spontaneous nystagmus. One-way analysis of variance (ANOVA test) was used to analyze the groups. Results Normal vHIT responses without refixation saccades but with lower gain were detected in 10 patients (29.4%). Fourteen patients (41%) showed abnormal vHIT results either in the form of normal or low VOR gain with refixation saccades. Six patients (42%) demonstrated dysfunction of both vestibular nerves. Of the 8 patients with unilateral refixation saccades, 2 patients (25%) had involvement of both vestibular nerve divisions, 2 patients had (25%), the superior vestibular nerve, and 4 patients (50%) had inferior vestibular nerve involvement. Conclusion Results suggest that the peripheral vestibular system is likely affected during migraine-associated vertigo. Re-fixation saccades were detected by vHIT in nearly half of the patients (42%). However, no specific pattern has been found. Inferior vestibular nerve involvement was more frequent.