Age-related features in vestibular migraine onset: A multiparametric analysis

Background: Clinical heterogeneity is a peculiarity of vestibular migraine, in contrast to other vestibular disorders that have a more stereotypical expression. Migraine presents a range of variability in symptoms depending on the age of the patient. Supposing that migraine headache and vestibular migraine share the same pathogenetic mechanisms, a multiparametric analysis was performed to verify the hypotheses of an age-related influence on the clinical features of vestibular migraine at the onset. Methods: In this retrospective study, we analysed the clinical records of 72 consecutive patients affected by vestibular migraine from June 2012 to November 2018: 64 females and eight males; mean age 38.2 ± 9.6. We considered only patients that reported onset of vestibular symptoms within 12 months preceding inclusion into the study. Results: Statistical analysis shows a significant increase in the diagnosis of probable vestibular migraine with increasing age and a decrease in vestibular migraine diagnosis (p = 0.034). The incidence of spontaneous dizziness increases with age (p = 0.012); by contrast, external spontaneous vertigo, and visually induced vertigo decrease after 40 years of age (p = 0.018), clinically characterising the onset of juvenile forms. Spontaneous vertigo, head motion-induced vertigo/dizziness, and positional vertigo did not show significant variations with age. Conclusion: Our data show that the type of vestibular symptoms in vestibular migraine varies according to the age of onset.