Prevalence and Clinical Features of Vestibular Migraine in Different Age Groups: Systematic Review and Meta-Analysis

Introduction: Vestibular migraine (VM) is a frequent but underdiagnosed cause of episodic vertigo, characterized by vestibular symptoms often accompanied by migrainous features. Despite its relatively high prevalence, diagnosis remains clinically challenging and may differ depending on the diagnostic criteria used. This systematic review evaluates VM prevalence and clinical features across age groups to improve recognition and guide age-appropriate management. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. This research was conducted using PubMed, Google Scholar, Cochrane, Web of Science, Wiley Online Library, and Embase. Two independent reviewers screened studies by title and abstract, and a separate pair screened full texts. Eligible studies were observational and reported prevalence or clinical features of VM. Results: A total of 874 publications were identified, leading to the review of 21 studies. Prevalence of VM varied widely, ranging from 6% to 35% in children and 2.7% to 40.9% in adults. Pooled prevalence across studies was 19% overall, 25% in children, and 14% in adults. Among patients with vertigo, the pooled prevalence was higher at 26%, with 33% in children and 18% in adults. Vertigo was the most consistent symptom in both age groups, and female predominance was observed in all age groups. Prevalence variability likely reflects diversity in applied diagnostic criteria and study design across included studies. Conclusion: VM is a common cause of vertigo, particularly in pediatric populations. Age-specific clinical features highlight the need for tailored diagnostic and management strategies. Future research should focus on large-scale prospective studies.