Dizziness and vertigo during the prodromal phase and headache phase of migraine: A systematic review and meta-analysis

Afrim Iljazi, Håkan Ashina, Richard B. Lipton, Basit Chaudhry, Haidar M. Al-Khazali, James G. Naples, Henrik W. Schytz, Vlasta Vukovic Cvetkovic, Rami Burstein, Sait Ashina

Research output: Contribution to journalReview article

Abstract

Objective: To assess the proportion of individuals who report dizziness and/or vertigo during the prodromal phase or headache phase of migraine. Methods: The databases of MEDLINE and EMBASE were searched for studies on dizziness and/or vertigo during the prodromal phase or headache phase of migraine. Pooled relative frequencies were estimated using a random-effects meta-analysis. Results: We identified nine articles eligible for inclusion. Of these, one study reported results for the prodromal phase, seven studies for the headache phase and one study for both the prodromal and headache phase. In the prodromal phase, 9.0% of individuals with migraine reported dizziness, while 3.3% reported vertigo. During the headache phase, relative frequency of dizziness ranged from 6.7% to 59.6%, while vertigo ranged from 6.4% to 44.7%. The meta-analysis showed a relative frequency of 35.7% for dizziness (95% CI = 13.7–61.5%, I2 = 99%) and 33.9% for vertigo (95% CI = 26.7–41.5%, I2 = 87%). Study quality was rated 5/9 or below for seven studies and 6/9 or above for two studies. Conclusion: We found that there is a scarcity of literature on dizziness and vertigo as prodromal- and headache-associated symptoms in individuals with migraine. Methodological variations confound comparisons of epidemiological patterns, although it appears that dizziness and vertigo are more frequent during the headache phase of migraine, compared with the prodromal phase. Future studies should ensure use of standardized definitions and rigorous methodology to enable accurate measurements of dizziness and vertigo in migraine.

Original languageEnglish (US)
JournalCephalalgia
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • associated symptoms
  • classification
  • Epidemiology
  • vestibular migraine
  • vestibular symptoms

ASJC Scopus subject areas

  • Clinical Neurology

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    Iljazi, A., Ashina, H., Lipton, R. B., Chaudhry, B., Al-Khazali, H. M., Naples, J. G., Schytz, H. W., Vukovic Cvetkovic, V., Burstein, R., & Ashina, S. (Accepted/In press). Dizziness and vertigo during the prodromal phase and headache phase of migraine: A systematic review and meta-analysis. Cephalalgia. https://doi.org/10.1177/0333102420921855