Abstract Details

Title Oculomotor, vestibular, reaction time, and cognitive assessment in vestibular migraine

Topic Headache

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 15-004

Objective To test oculomotor, vestibular, reaction time, and cognitive (OVRT-C) metrics in patients with vestibular migraine, and to identify any patterns that may aid in diagnosis of this disorder.

Background Vestibular migraine is a poorly understood and likely underdiagnosed disorder. Making this diagnosis is challenging due to its clinical overlap with other vestibular disorders, and conflicting information in the medical literature about what should or should not be seen on neurologic/vestibular examination in these patients.

Design/Methods Subjects were recruited from a tertiary headache center. Subjects with a clinical diagnosis of vestibular migraine were assessed with a battery of OVRT-C tests using video oculography. The test battery included multiple metrics of nystagmus, saccades, antisaccades, smooth pursuit, vestibular function, and reaction time (visual and auditory). Subjects also underwent bedside neurologic and vestibular examination and answered the Dizziness Handicap Inventory (DHI). OVRT-C measures were compared with those from a database of 466 heathy adults.

Results 32 subjects (24 female, age range 18-70, mean age 41) participated in the study. There were significant differences in multiple OVRT-C metrics between the migraine patients and controls using logistic regression analysis. These metrics include increased latency and undershooting of saccades, increased percentage of saccadic intrusion in smooth pursuit, and decreased optokinetic nystagmus gain.

Conclusions Patients with a clinical diagnosis of vestibular migraine demonstrate characteristic abnormalities on OVRT-C testing when compared to non-affected individuals. This may lead to improved diagnosis and potentially illuminate more of the underlying pathophysiology of this disorder. Further investigation may allow for the development of a testing battery to discriminate vestibular migraine from other clinically similar disorders.

Authors/Disclosures
Claire Ceriani, MD (Thomas Jefferson University) PRESENTER	Dr. Ceriani has nothing to disclose.
	No disclosure on file
Alex Kiderman	Dr. Kiderman has received personal compensation for serving as an employee of Neurolign Technology Inc. The institution of Dr. Kiderman has received research support from NIH.

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