Correlation Between Central Oculomotor Test and Balance Functions in Vestibular Migraine

Abstract

Background: Vestibular migraine is a prevalent neurological disorder that is characterised by episodic vertigo, often accompanied by migraine symptoms. The relationship between central oculomotor abnormalities and balance impairment remains unexplored in Vestibular migraine. Objective: This study aimed to compare and evaluate central oculomotor and balance functions of individuals with vestibular migraine and age and gender matched healthy controls. The study also aimed to identify correlations between central oculomotor functioning and balance performance in vestibular migraine patients. Methods: this study included 40 participants which were divided into two groups. Group I had 20 individuals diagnosed with vestibular migraine and 20 age and gender matched healthy controls. They underwent videonystagmography, craniocorpography and stabilometry and were assessed on parameters such as saccadic latency, smooth pursuit and optokinetic gain, the body axis spin and angular deviation in Unterberger test, forward movement and maximum lateral sway in tandem walking test, anteroposterior sway and lateral sway in Romberg test, the sensory functioning scores and left right symmetry stability. Results: Individuals with vestibular migraine demonstrated significantly lower smooth pursuit gain compared to the controls. The differences in saccadic latency and optokinetic gain were not statistically significant. The vestibular migraine patients also show poor performance in the Romberg test as compared to controls, and the differences in the Unterberger and tandem walking tests were not statistically significant. The vestibular functioning scores were poorer in the vestibular migraine group, also they had more asymmetry as compared to the healthy controls. Conclusion: The findings highlight the presence of subtle central oculomotor dysfunction in vestibular migraine, particularly affecting smooth pursuit. The balance tests may not always reveal significant differences, the combined use of VNG, CCG and Stabilometric measures can provide a more comprehensive assessment. These results support the integration of multimodal vestibular evaluations in the diagnostic evaluation and rehabilitation planning for vestibular migraine.