Differences in vestibulo-ocular reflex time constants in patients with vestibular migraine versus vestibular neuritis/labyrinthitis
Abstract
OBJECTIVE: Recurrent dizziness, vertigo, and imbalance, as well as nausea or vomiting, can be induced by central or peripheral vestibular pathology. Vestibular migraine (VM) is a central pathology in which migraines reciprocally interact with vestibular nuclei. Vestibular neuritis and labyrinthitis (VN/L) are peripheral diseases involving inflammation of structures in the vestibular nerve or labyrinth. Because VM and VN/L in early stages can produce similar symptoms, diagnosis may require prolonged clinical evaluation. It has been suggested that differences in a patient's Vestibulo-Ocular Reflex (VOR) measured during the rotary chair step rotation test (RCS Test) can differentiate VM from peripheral pathologies, allowing for faster diagnosis. We sought to compare VOR time constants (VORTcs) in patients with VM versus VN/L, with the goal of exploring potential diagnostic value.
STUDY DESIGN: Retrospective chart review of patients seen at a hospital balance center between January 2010 and June 2019.
SETTING: Tertiary referral center.
PATIENTS: 68 patients (mean age = 58.15, 65 % female, 35 % male) were placed into two groups based on clinical diagnosis codes: 1) VM or 2) VN/L.
MAIN OUTCOME MEASURE(S): Primary variable of VORTc, evoked by rotational step testing.
RESULTS: Patients in the VM group demonstrated statistically significant elevated VOR Tcs outside the normed range of 10-19.5 compared to those in the VN/L group (p = 0.0003) while patients in the VN/L group…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 68 participants or records.
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