Investigating the relationship between vasovagal syncope and migraine: a case-control study among Lebanese patients

Background: This study investigates the association between migraines and vasovagal syncope (VVS), focusing on shared autonomic dysfunction mechanisms in a Middle Eastern population. Methods: Using a case-control design, 163 participants (57 with migraines and 106 controls) were assessed through validated tools, including the Migraine Disability Assessment (MIDAS) and Patient Health Questionnaire-4 (PHQ-4). Results: Multivariable analyses results demonstrated a significant association between migraines and VVS, with migraine patients exhibiting nearly threefold higher odds of VVS. Gender differences were pronounced, with females displaying higher susceptibility. Additional drug use and comorbid conditions were also significant factors. Interestingly, the MIDAS score was not found to be significantly correlated with VVS, highlighting the intricacy of autonomic dysfunction. Conclusions: These findings underline that screening for autonomic dysfunction must be conducted in migraine patients and that gender-specific approaches should be adopted in their clinical management. Further research is needed to study the causative pathways and to validate these findings in a large and varied population.