Migraine is associated with an increased risk for benign paroxysmal positional vertigo: a nationwide population-based study

Background: There is evidence suggesting that migraine may be associated with vertigo. The aim of this study was to assess the risk of benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, in patients with migraine using a population-based dataset. Methods: The National Health Insurance Research Database in Taiwan was searched for migraine patients and was also used to select an age- and sex-matched cohort of subjects without migraine. The analyses included 8266 migraine patients and 8266 controls. The incidence rates of BPPV in the two cohorts were compared. Cox proportional hazard models were used to identify risk factors for BPPV in migraine patients. Results: In the migraine cohort, 1.11 % of the patients developed BPPV compared to 0.5 % of the controls. The incidence rate ratio was 2.03 (95 % CI 1.41–2.97; p <0.001). Cox proportional hazards analysis showed that age ≥40 years (HR 2.20; 95 % CI 1.40–3.45; p = 0.001), coronary artery disease (HR 4.62; 95 % CI 1.12–19.01; p = 0.034), and the number of outpatient department visits to neurologists because of migraine (HR 2.93; 95 % CI 2.50–3.44; p >0.001) were associated with an increased risk for BPPV. Conclusion: The results showed that patients with migraine had a 2.03-fold increased risk of developing BPPV compared with age- and sex-matched controls. Although BPPV may not be a common condition in migraine patients, migraine sufferers with vestibular symptoms should alert physicians to the possibility of BPPV, particularly if patients are aged ≥40 years, have a history of coronary artery disease, or have frequent visits to neurologists clinics because of migraine.