Simple Exams Work in Vestibular Testing: Up to 50% of Migraineurs Have Vestibular Symptoms, Including Dizziness, Motion Sensitivity

By Norton, Patrice G. W. | Clinical Psychiatry News, January 2004 | Go to article overview

Simple Exams Work in Vestibular Testing: Up to 50% of Migraineurs Have Vestibular Symptoms, Including Dizziness, Motion Sensitivity


Norton, Patrice G. W., Clinical Psychiatry News


CHICAGO -- Three simple bedside exams are more accurate than most laboratory tests in eliciting objective evidence of vestibular abnormalities in patients with migraine, Dr. David Zee said at the annual meeting of the American Headache Society.

Some studies suggest that more than 50% of migraineurs have some type of vestibular symptoms, including dizziness, unsteadiness, and motion sensitivity. Specialized vestibular testing such as electronystagmography (ENG) is commonly used in patients with migraine and vestibular symptoms, but the results often are not specific, said Dr. Zee, director of the vestibular-eye movement clinic and testing laboratory at Johns Hopkins University, Baltimore.

"There are a couple of things you can do at the bedside that are far better than any vestibular function test you are going to get from a laboratory," he said.

The biggest issue is that quality control of ENG testing is extremely poor, so testing is subject to variability and artifact.

Dr. Zee urged caution when evaluating the results of vestibular function tests, including ENG and posturography, as he does even from his own lab. "Your bedside exam is far more accurate when there is a significant loss of vestibular function on one side."

Up to 25% of migraineurs with vestibular symptoms have been reported to have a reduced response to caloric stimulation upon laboratory testing, which suggests a decrease in labyrinthine sensitivity.

As many as 65% have been reported to have interictal central eye movement abnormalities such as gaze-evoked nystagmus or impaired pursuit.

Dr. Zee said he recommends three bedside exams that take about a minute to perform:

* Use an ophthalmoscope to detect spontaneous nystagmus. This test is performed during routine ophthalmoscopy, which is conducted on all migraine patients. The physician examines the optic nerve head for stability while covering and then uncovering one eye. This eliminates visual fixation and will bring out or exacerbate spontaneous nystagmus if present.

The patient also can be asked to move his or her head gently from side to side while covering each eye. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Simple Exams Work in Vestibular Testing: Up to 50% of Migraineurs Have Vestibular Symptoms, Including Dizziness, Motion Sensitivity
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.