AUTHOR=Celebisoy Nese , Kısabay Aysın , Özdemir Hüseyin Nezih , Gokcay Figen , Sarıtas Aysegul Seyma , Toydemir Hulya , Yayla Vıldan , Isıkay Ilksen , Erkent İrem , Atac Ceyla , Bıcakcı Sebnem , Güleç Feray , Kartı Dılek Top , Goksu Eylem Ozaydın 

TITLE=Vestibular migraine: course of symptoms during a four-year follow-up

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1567233

DOI=10.3389/fneur.2025.1567233

ISSN=1664-2295

ABSTRACT=Background and objectiveData about the prognosis of vestibular migraine (VM) is scarce. VM patients on follow-up for at least 4 years were included in this multicenter study to evaluate the course of symptoms.MethodsThis is a cross-sectional study. A structured questionnaire was used inquiring demographic features, age of onset of migraine headaches and vertigo attacks, headache and vertigo attack frequency, severity, associated features and the presence of interictal dizziness and positional vertigo. Menopause, history of motion sickness, and family history of migraine were recorded. Answers of the first visit were compared with the answers of the last visit. In addition, variables considered were evaluated regarding their effect on the symptom course.Results203 patients were studied. Median vertigo and headache attack frequency and severity had significantly dropped during follow-up (p < 0.01 for all comparisons). Complete resolution was reported by only 5.4%. Dizziness between the attacks was present in 67%, and positional vertigo was reported by 20.2%. Univariate analysis showed that aural symptoms (p = 0.013) and menopause (p = 0.016) were risk factors for ongoing frequent vertigo attacks. A history of motion sickness (p = 0.019) and a family history of migraine (p = 0.004) were associated with the risk of frequent migraine headaches. The presence of allodynia (p = 0.002) was associated with severe headache attacks while an early age of onset of vertigo attacks (p = 0.005) was a risk factor for continuing high-frequency vertigo attacks.ConclusionThough the frequency and severity of headache and vertigo attacks decrease, complete resolution is reported by a minority.