Affiliations: [a]
Department of Health and Rehabilitation Sciences, Temple University, Philadelphia PA, USA
| [b]
Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia PA; currently Division of Otolaryngology, St. Christopher’s Hospital for Children, Philadelphia PA, USA
| [c]
Temple University School of Medicine, Philadelphia PA, USA
| [d]
Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
Correspondence:
[*]
Corresponding author: Dr. Emily A. Keshner, Department of Health and Rehabilitation Sciences, Temple University, Ritter Annex Room 683, 1301 Cecil B. Moore Avenue, Philadelphia PA 19122, USA. E-mail: ekeshner@temple.edu.
Abstract: BACKGROUND:Dizziness affects 20–30%of the general population. A subgroup of dizzy patients with chronic migraine suffers vertigo implying that the migraine has a vestibular component. Vestibular migraine remains a diagnosis of exclusion based on history. OBJECTIVE:A link between headaches and dizziness suggests that these individuals would demonstrate dizziness and instability in complex, dynamic visual environments as a result of an inability to correctly process conflicting visual and vestibular signals. METHODS:A convenience sample of 74 patients (22 men and 52 women; average age 56.2 years) who presented with complaints of dizziness participated. Effects of Visual-Vestibular Mismatch (VVM) were measured using a modified VVM questionnaire. Visual dependence was measured as the error to subjective visual vertical using a computerized Rod and Frame test. RESULTS:Forty-two participants (56.8%) tested positive for VVM. Of these, 68.9%were patients with concomitant complaints of headaches. Visual dependence was present in 41.5%of all patients but showed no significant correlation with headache. 22.2%of patients had visual dependence and complained of headaches. CONCLUSIONS:These results demonstrate that sensory reweighting occurs in patients experiencing dizziness and headache, supports the role of vestibular involvement in this disorder, and provides future direction for novel interventions.
Keywords: Migraine, dizziness, visual dependence, rod and frame, vertigo
