Vestibulo-Ocular Reflex Abnormalities in Patients With Migraine


  • Melvin R. Helm MD

  • From the California Headache & Balance Center, Fresno, CA.

Address all correspondence to Dr. Melvin R. Helm, California Headache & Balance Center, 1313 E. Herndon Ave. Suite 207, Fresno, CA, 93720.


Objective.—To investigate the high-frequency vestibulo-ocular reflex (VOR) in patients with migraine, with and without dizziness and aura.

Background.—Migraine is a common cause of dizziness. Although many vestibular testing abnormalities have been documented in migraine patients, high-frequency VOR abnormalities have not been reported.

Methods.—Thirty-nine consecutive patients with migraine were studied with the vestibular autorotation test (VAT®). The patients were subclassified as having migraine headache only, migraine with visual aura, migraine with dizziness, or migraine with visual aura and dizziness.

Results.—Only a high vertical phase in the 4 to 5 Hz range was correlated with migraine (correlation coefficients: .356, P= .03). Further analysis revealed that an abnormal 4 to 5 Hz vertical phase result also was positively correlated with migraine with aura and dizziness (correlation coefficients: .392).

Conclusion.—The results suggest that patients with migraine may have an abnormal vertical VOR at higher head movement frequencies. Migraine patients with visual aura and dizziness are even more likely to have this abnormality.