Vincent Van Gogh and the elusive diagnosis of vestibular migraine

Abstract

Vincent Van Gogh (1853–1890) was a creative genius and one of the greatest painters in history. He was a troubled soul plagued with an inner turmoil driven by his social, financial, personality and medical/psychiatric afflictions. His life has fascinated academic scholars of many disciplines who have researched extensively on his life and works. From his voluminous correspondences and contemporary medical records, his medical/psychiatric illnesses have been analysed in detail and several diagnostic formulations proposed. These include temporal lobe epilepsy, intermittent acute porphyria, Meniere’s disease, lead poisoning, sexually transmitted diseases, terpene/absinthe/alcohol abuse, ophthalmological disorders in addition to chronic bipolar disorder, schizophrenia, personality and anxiety disorder and narcissism/neuroticism. We hypothesized a new diagnosis in the form of vestibular migraine for Van Gogh which is a migraine variant but distinct from the classical migraine variety. Our hypothesis is unique as it also considers that this condition due to its recognised associations with Van Gogh’s proposed illnesses could have influenced his other conditions and thus offers a common unifying factor to explain his illness symptoms. We tested our hypothesis by individually analysing all of Van Gogh’s correspondences in the original French and Dutch as well as English translations. Further, we considered the existing literature on Van Gogh’s other illnesses and contemporary medical records. Van Gogh fulfilled all the criteria for vestibular migraine as formulated by Barany Society and International Classification of Headache Disorders (ICHD) 3 with episodic dizziness, present or past history of classical migraine, headache, photophobia, phonophobia and visual and position triggered vertigo with no other otologial cause to explain his symptoms (including Meniere’s disease). Furthermore, it appears that vestibular migraine could have interacted with most of his other proposed illnesses. We also observed that this condition influenced his art following onset for example, in his use of colours and depiction of his subject matter with a consistent vertical tilt on the left. It is anticipated that our hypothesis will add a new dimension to the understanding of his illnesses and increase the awareness of the complex condition of vestibular migraine that to this day has limited awareness amongst the medical and general fraternity.