Eye Movement Abnormalities During Different Periods in Patients with Vestibular Migraine

Abstract

Purpose

The aim of this study was to assess abnormal eye movement signs during different periods, namely, ictal periods and symptom-free intervals, in patients with vestibular migraine.

Patients and Methods

We assessed oculomotor signs using videonystagmography in 90 patients with VM (40 during ictal periods and 50 during symptom-free intervals) according to validated diagnostic criteria.

Results

Abnormal saccades, smooth pursuit and optokinetic test results; spontaneous nystagmus; and positional nystagmus were all observed in vestibular migraine patients, and there was no significant difference between different periods. Positional nystagmus was the most common in both the ictal and asymptomatic periods (60% and 36%, respectively). Positional nystagmus was induced in a variety of positions during both periods, and the slow-phase velocity ranged from <2 to 10°/s. The duration of positional nystagmus was over 60s in most cases. Overall, central oculomotor dysfunctions occurred in 27.5% of patients during VM attacks and 4% of patients during symptom-free intervals; this difference was statistically significant (p = 0.002).

Conclusion

In patients with VM, abnormal oculomotor signs can be found during both vertigo attacks and asymptomatic intervals. Positional nystagmus is the most common of these abnormalities and can be induced in different positions. The amplitude of these patients’ positional nystagmus tends to be low, and the duration tends to be long. Observing changes in eye movements by videonystagmography may be helpful in the diagnosis of VM.

Keywords:

• vestibular migraine
• eye movements
• periods
• videonystagmography
• positional nystagmus

Ethics Statement

This study was approved by the Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University. Patient informed consent to review their medical records was waived by the Institutional Review Board of Beijing Tiantan Hospital, Capital Medical University, because this was a retrospective study, the data recorded from the patient file will be treated confidentially and data excludes the display of names and other personal information. No reference is made in written reports that could associate the participants with the study. The study was conducted in accordance with the principles set out in the Declaration of Helsinki.

Disclosure

The authors have no conflict of interest to report.