Association Between Interictal Sensory Hypersensitivities and Vestibular Symptoms in Migraine: A Cross‐Sectional Study

Background Dizziness and vertigo are common in migraine patients. This study investigated the relationship between vestibular symptoms and interictal hypersensitivities. Methods A cross‐sectional survey was conducted in migraine patients from a headache unit and a neurology clinic. Results Among 274 participants (87.2% female, mean age 41.7 ± 12.4 years), interictal sensory hypersensitivities were common: 76 (27.7%) reported photophobia, 67 (24.5%) phonophobia, and 69 (25.2%) osmophobia. Vestibular symptoms were also common: dizziness 148 (54.0%) and vertigo 119 (43.8%).Vestibular symptoms were more prevalent in patients with interictal symptoms: photophobia (dizziness 77.6% vs. 47.1%, p < 0.001; vertigo 68.0% vs. 33.8%, p < 0.001), phonophobia (dizziness 74.6% vs. 47.3%, p < 0.001; vertigo 61.2% vs. 37.7%, p < 0.001), and osmophobia (dizziness 66.7% vs. 49.8%, p = 0.015; vertigo 56.5% vs. 39.4%, p = 0.011). Patients with interictal sensory hypersensitivities had higher Dizziness Handicap Inventory (DHI) scores: photophobia (57.9 ± 20.7 vs. 45.1 ± 22.3, p < 0.001), phonophobia (55.6 ± 20.2 vs. 47.5 ± 23.2, p = 0.037), and osmophobia (53.1 ± 22.3 vs. 48.9 ± 22.5, p = 0.299).In multivariable analysis, the number of interictal hypersensitivities predicted dizziness (OR 1.74, p = 0.002) and vertigo (OR 1.72, p < 0.001). Having ≥ 15 headache days/month was the strongest predictor of dizziness (OR 3.30, p = 0.001), while nausea was the strongest predictor of vertigo (OR 3.86, p < 0.001). Conclusions Vestibular symptoms are highly prevalent in migraine and strongly associated with interictal hypersensitivities. The number of affected sensory modalities predicts both prevalence and severity. Higher burdens of migraine and nausea are key predictors of dizziness and vertigo, respectively.