Are migraine and benign paroxysmal positional vertigo associated diseases? An experience of medical college attached hospital from the western part of India

Objectives: Repeated migraine attacks may cause vestibular dysfunction and dislodge of otoconia from utricle to semicircular canals resulting in benign paroxysmal positional vertigo (BPPV). The aim of the present study was to evaluate risk factors and linkage of migraine in patients of BPPV. Material and Methods: This observational case-control study was conducted at Zydus medical college and hospital, Dahod, India from October 2018 to September 2019. Consecutive 18 to 70 years old patients of confirmed BPPV were assigned as the cases. Demographically matched healthy volunteers were assigned as the controls. The cases, as well as the control, were further evaluated for a past or present history and a family history of migraines. Results: 295 consecutive BPPV cases (250 posterior canals, 45 horizontal canals) and 300 control subjects were studied. In the case group, 55 (18.64%) were having past or present migraine (45 migraines without aura, 8 migraines with aura and 2 vestibular migraines), while in the control group 24 (8.0%) were having migraine (20 migraines without aura, 4 migraines with aura). Among BPPV patients, those associated with migraines were younger and more often females, with many having a history of diabetes mellitus and coronary artery disease and family/past history of migraines. Migraine was 2.3 times higher in cases as compared to the control with significant or Odds Ratio of 2.63 and 2.68 in unadjusted and adjusted analysis respectively. Conclusion: Migraine was more than two times more common in BPPV patients as compared to the age and sex-matched controls. Keywords: Headache, Benign paroxysmal positional vertigo, BPPV, Migraine, Vestibular migraine, Migraine Variants