Is Balance Normal in Migraineurs Without History of Vertigo?

OBJECTIVE: To investigate by static posturography the occurrence of balance disorder in migraineurs without a history of vertigo during the interictal period. BACKGROUND: The link between migraine and balance disorders has long been known but postural balance in migraineurs without manifest vestibulopathy has been rarely studied. METHODS: We studied 25 migraineurs and age- and gender-matched controls. With static posturography we measured: (1) postural sway with eyes open or closed on a platform or on foam with 4 different head positions; (2) limits of stability as patients change their center of gravity to reach to 8 different points; (3) tandem walking. RESULTS: With eyes open, sway velocity was significantly greater in migraineurs than in controls while standing on a firm surface with head backwards or on a foam surface in all head positions. With eyes closed, sway velocity was significantly greater in migraineurs than in controls only while standing on a foam surface with head backwards or turned sideways. Migraineurs also had an offset center of gravity alignment in all conditions and their average reaction time and maximal excursions were significantly greater in the limits of stability test. In tandem walking, step width was significantly wider and walk speed was significantly slower in migraineurs. CONCLUSION: Our findings support the notion that there is a slight but significant postural instability in migraineurs and it is of central vestibular origin.