title: Migrainous vertigo: prevalence and impact on quality of life.
abstract: OBJECTIVE
  To investigate the epidemiology of migrainous vertigo (MV) in the general population by assessing prevalence, clinical features, comorbid conditions, quality of life, and health care utilization.
  
  
  METHODS
  We screened a representative sample of the adult population in Germany (n = 4,869) for moderate or severe dizziness/vertigo and followed up with validated neurotologic telephone interviews (n = 1,003). Diagnostic criteria for MV were as follows: 1) recurrent vestibular vertigo; 2) migraine according to the International Headache Society; 3) migrainous symptoms during at least two vertiginous attacks (migrainous headache, photophobia, phonophobia, or aura symptoms); and 4) vertigo not attributed to another disorder. In a concurrent validation study (n = 61) the interviews had a sensitivity of 84% and a specificity of 94% for vestibular vertigo and 81% and 100% for migraine.
  
  
  RESULTS
  The lifetime prevalence of MV was 0.98% (95% CI 0.70 to 1.37), the 12-month prevalence 0.89% (95% CI 0.62 to 1.27). Spontaneous rotational vertigo was reported by 67% of participants with MV while 24% had positional vertigo. Twenty-four percent always experienced headaches with their vertigo. Logistic regression analysis comparing participants with MV with dizziness-free migraineurs showed an independent association with coronary heart disease but not with sex, age, migrainous aura, education, stroke, hypertension, hyperlipidemia, body mass index, or depression. Age-adjusted health-related quality of life scores (SF-8 Health Survey) were consistently lower in participants with MV compared to dizziness-free controls. Two thirds of participants with MV had consulted a doctor but only 20% of these were diagnosed with MV.
  
  
  CONCLUSIONS
  Migrainous vertigo is relatively common but underdiagnosed in the general population and has considerable personal and healthcare impact.
authors.affiliation: Department of Epidemiology, Robert Koch Institute, Berlin, Germany. neuhauserh@rki.de
authors.forename: H K
authors.initials: HK
authors.lastname: Neuhauser
authors.forename: A
authors.initials: A
authors.lastname: Radtke
authors.forename: M
authors.initials: M
authors.lastname: von Brevern
authors.forename: M
authors.initials: M
authors.lastname: Feldmann
authors.forename: F
authors.initials: F
authors.lastname: Lezius
authors.forename: T
authors.initials: T
authors.lastname: Ziese
authors.forename: T
authors.initials: T
authors.lastname: Lempert
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D014717:Vertigo / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*