Journal of Neurology

, Volume 266, Issue 1, pp 242–244 | Cite as

Video head impulse findings in the ictal period of vestibular migraine

  • Seunghee Na
  • Eek-Sung Lee
  • Jong Dae Lee
  • Ki-Bum Sung
  • Tae-Kyeong LeeEmail author
Letter to the Editors

Dear Sirs,

Vestibular migraine (VM) manifests as central or peripheral vestibular dysfunction during vertigo attacks [1]. However, no studies have reported the findings of video head impulse tests (vHIT) during the ictal period of VM. Herein, we report unique findings of vHIT in a patient with VM during a vertigo attack.

A 40-year-old man presented with positional vertigo without auditory symptoms. Sitting up from the supine position, but not vice versa, aggravated his vertigo. Over a 4-year period, he had suffered from several episodes of vertigo lasting from 48 to 72 h that was followed by a migrainous headache with photophobia, phonophobia, and nausea for 1–2 days. He reported that the clinical features of this vertigo were quite similar to previous recurrent attacks. His symptoms met the Barany Society’s diagnostic criteria for vestibular migraine [2]. His father and older sister also had recurrent episodes of headache without vertigo.

On examination, the patient veered slightly to...



This work was supported by the Soonchunhyang University Research Fund. The authors thank Jin-Sung Lim for technical assistance and Ji-Soo Kim for his helpful comments on this case.

Conflicts of interest

The authors declare that they have no competing interest.

Ethical standards

The authors declare that this single case report has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Supplementary material

Video Legend Video recording of video head impulse tests during stimulation of the right anterior canal and left posterior canal. Initially, undershoot of vestibular ocular reflex and corrected saccades occurred. Similar patterns were documented 4 days after vertigo onset. During the follow-up period, these patterns gradually disappeared. (MP4 8640 KB)


  1. 1.
    Strupp M, Versino M, Brandt T (2010) Vestibular migraine. Handb Clin Neurol 97:755–771CrossRefPubMedGoogle Scholar
  2. 2.
    Lempert T, Olesen J, Furman JM et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22:167–172PubMedGoogle Scholar
  3. 3.
    Kim SH, Zee DS, du Lac S, Kim HJ, Kim JS (2016) Nucleus prepositus hypoglossi lesions produce a unique ocular motor syndrome. Neurology 87:2026–2033CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Mantokoudis G, Tehrani AS, Kattah JC, Eibenberger K, Guede C, Zee DS et al (2015) Quantifying the vestibulo–ocular reflex with video-oculography: nature and frequency of artifacts. Audiol Neurootol 20:39–50CrossRefPubMedGoogle Scholar
  5. 5.
    Kim HJ, Lee SH, Park JH, Choi JY, Kim JS (2014) Isolated vestibular nuclear infarction: report of two cases and review of the literature. J Neurol 261:121–129CrossRefPubMedGoogle Scholar
  6. 6.
    Park HK, Kim JS, Strupp M, Zee DS (2013) Isolated floccular infarction: impaired vestibular responses to horizontal head impulse. J Neurol 260:1576–1582CrossRefPubMedGoogle Scholar
  7. 7.
    Dieterich M, Brandt T (1993) Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs. Ann Neurol 33:292–299CrossRefPubMedGoogle Scholar
  8. 8.
    Kim HA, Hong JH, Lee H, Yi HA, Lee SR, Lee SY, Jang BC, Ahn BH, Baloh RW (2008) Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery. Neurology 70:449–453CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurology, Incheon St. Mary’s HospitalThe Catholic University of KoreaIncheonSouth Korea
  2. 2.Department of NeurologySoonchunhyang University College of MedicineBucheonSouth Korea
  3. 3.Department of Otorhinolaryngology-Head and Neck SurgerySoonchunhyang University College of MedicineBucheonSouth Korea

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