J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 6, June 2025, pages 344-355

Clinical Features of Migraine, Vestibular Migraine, and Tension-Type Headache and Their Vestibular Evoked Myogenic Potential Study

↓ **Table 1.** Patient Demographic for the Three Primary Headaches
	Migraine (n = 118)	VM (n = 150)	TTH (n = 85)	P-value
Continuous variables: mean ± standard deviation (SD); count variables: %. 1: migraine group, 2: VM group, 3: TTH group. TTH: tension-type headache; VM: vestibular migraine.
Age (years), mean ± SD	38.47 ± 13.28	40.77 ± 14.10	47.08 ± 10.94	P > 0.05	P < 0.001	P < 0.001
Male sex, (%)	37 (31.36%)	31 (20.67%)	34 (40%)	P < 0.05	P > 0.05	P < 0.01
Sleep disorder (%)	44 (37.29%)	63 (42%)	56 (65.88%)	P > 0.05	P < 0.001	P < 0.001
Depression and anxiety (%)	20 (16.95%)	42 (28%)	47 (55.29%)	P < 0.05	P < 0.001	P < 0.001
Hypertension (%)	9 (7.63%)	22 (14.67%)	14 (16.47%)	P > 0.05	P > 0.05	P > 0.05
Diabetes (%)	3 (2.54%)	2 (1.33%)	3 (3.53%)	P > 0.05	P > 0.05	P > 0.05
Abortive treatment (%)	89 (75.42%)	49 (32.67)	7 (8.23%)	P < 0.001	P < 0.001	P < 0.001
Triggers (%)	43 (36.44%)	56 (37.33%)	18 (21.18%)	P > 0.05	P < 0.05	P < 0.02
Visual aura (%)	27 (22.88%)	24 (16%)		P > 0.05
Familiar history (%)	15 (12.71%)	14 (9.33%)	4 (4.71%)	P > 0.05	P < 0.05	P > 0.05

↓ Table 1. Patient Demographic for the Three Primary Headaches

Migraine (n = 118)

VM (n = 150)

TTH (n = 85)

P-value

1 vs. 2

1 vs. 3

2 vs. 3

Continuous variables: mean ± standard deviation (SD); count variables: %. 1: migraine group, 2: VM group, 3: TTH group. TTH: tension-type headache; VM: vestibular migraine.

Age (years), mean ± SD

38.47 ± 13.28

40.77 ± 14.10

47.08 ± 10.94

P > 0.05

P < 0.001

Male sex, (%)

37 (31.36%)

31 (20.67%)

34 (40%)

P < 0.05

P > 0.05

P < 0.01

Sleep disorder (%)

44 (37.29%)

63 (42%)

56 (65.88%)

P > 0.05

P < 0.001

Depression and anxiety (%)

20 (16.95%)

42 (28%)

47 (55.29%)

P < 0.05

P < 0.001

Hypertension (%)

9 (7.63%)

22 (14.67%)

14 (16.47%)

P > 0.05

Diabetes (%)

3 (2.54%)

2 (1.33%)

3 (3.53%)

P > 0.05

Abortive treatment (%)

89 (75.42%)

49 (32.67)

7 (8.23%)

P < 0.001

Triggers (%)

43 (36.44%)

56 (37.33%)

18 (21.18%)

P > 0.05

P < 0.05

P < 0.02

Visual aura (%)

27 (22.88%)

24 (16%)

P > 0.05

Familiar history (%)

15 (12.71%)

14 (9.33%)

4 (4.71%)

P > 0.05

P < 0.05

P > 0.05

↓ Table 2. Description of the Vertigo and/or Headache Complaints of the Three Groups

Clinical variables

Migraine (n = 118)

VM (n = 150)

TTH (n = 85)

P-value

1 vs. 2

1 vs. 3

2 vs. 3

**P < 0.01, the duration between headache and vertigo in VM. 1: migraine group, 2: VM group, 3: TTH group. TTH: tension-type headache; VM: vestibular migraine.

Disease duration, years, mean ± SD

Headache

9.21 ± 0.79

7.14 ± 0.70

4.40 ± 0.67

P < 0.05

P < 0.001

P < 0.02

Dizzy/vertigo

4.03 ± 0.44**

Duration of attack

0 - 4 h

Pain

68 (57.63%)

100 (66.67%)

P > 0.05

Vertigo or dizzy

105 (70%)

≤ 1 min

33 (22%)

15 (17.65%)

P > 0.05

4 - 24 h

Pain

36 (30.51%)

39 (26%)

P > 0.05

Vertigo or dizzy

21 (14%)

> 24 h

Pain

36 (30.51%)

11 (7.33%)

P > 0.05

Vertigo or dizzy

9 (6%)

TTH

Unsteady gait

5 (5.88%)

Continuous pain

68 (80%)

Continuous dizzy

44 (51.76%)

TTH accompanied dizzy and/or vertigo

63 (74.12%)

Attack rate

> 4 times a month

Pain

30 (25.42%)

34 (22.67%)

P > 0.05

Vertigo/dizzy

50 (33.33%)

1 - 4 times a month

Pain

38 (32.20%)

41 (27.33%)

P > 0.05

Vertigo/dizzy

35 (23.33%)

Less than once month

Pain

27 (22.88%)

71 (47.33%)

P < 0.001

Vertigo/dizzy

59 (39.33%)

Increased frequency

Pain

23 (19.49%)

4 (2.67%)

P < 0.001

Vertigo/dizzy

6 (4%)

Location of pain

Temple

52 (44.07%)

53 (35.33%)

P > 0.05

Occiput/neck

9 (7.63%)

36 (24%)

P < 0.001

Occiput/forehead

7 (4.67%)

P < 0.02

Occiput/temple

9 (7.63%)

8 (5.33%)

P > 0.05

Temple/forehead

9 (7.63%)

14 (9.33%)

P > 0.05

Hemicranial

22 (18.64%)

6 (4%)

P < 0.001

Indefinite

17 (14.41%)

26 (17.33%)

P > 0.05

↓ **Table 3.** Absent Vestibular Evoked Myogenic Potential Response, Either Bilaterally or Unilaterally
Group	Migraine (n = 118)	VM (n = 150)	TTH (n = 85)	P-value
1: migraine group, 2: VM group, 3: TTH group. AR: asymmetry ratio; cVEMP: cervical vestibular evoked myogenic potential; nHL: normal hearing level; oVEMP: ocular vestibular evoked myogenic potential; TTH: tension-type headache; VM: vestibular migraine.
Absent oVEMP at 95 dB nHL (including bilateral and unilateral)	34 (28.81%)	68 (45.33%)	34 (40.0%)	P < 0.01	P > 0.05	P > 0.05
Bilateral	13 (11.02%)	22 (14.67)	14 (16.47%)	P > 0.05	P > 0.05	P > 05
Unilateral	21 (17.80%)	46 (30.67%)	20 (23.53%)	P < 0.05	P > 0.05	P > 0.05
Absent cVEMP at 95 dB nHL	5 (4.24%)	10 (6.67%)	1 (1.18%)	P > 0.05	P > 0.05	P > 0.05
Bilateral	2	3	1
Unilateral	3	7	0
AR oVEMP ≥ 35%	22 (18.64%)	27 (18.0%)	15 (17.65%)	P > 0.05	P > 0.05	P > 0.05
AR cVEMP ≥ 35%	9 (7.63%)	18 (12.0%)	7 (8.24%)	P > 0.05	P > 0.05	P > 0.05

↓ Table 3. Absent Vestibular Evoked Myogenic Potential Response, Either Bilaterally or Unilaterally

Group

Migraine (n = 118)

VM (n = 150)

TTH (n = 85)

P-value

1 vs. 2

1 vs. 3

2 vs. 3

1: migraine group, 2: VM group, 3: TTH group. AR: asymmetry ratio; cVEMP: cervical vestibular evoked myogenic potential; nHL: normal hearing level; oVEMP: ocular vestibular evoked myogenic potential; TTH: tension-type headache; VM: vestibular migraine.

Absent oVEMP at 95 dB nHL (including bilateral and unilateral)

34 (28.81%)

68 (45.33%)

34 (40.0%)

P < 0.01

P > 0.05

Bilateral

13 (11.02%)

22 (14.67)

14 (16.47%)

P > 0.05

P > 05

Unilateral

21 (17.80%)

46 (30.67%)

20 (23.53%)

P < 0.05

P > 0.05

Absent cVEMP at 95 dB nHL

5 (4.24%)

10 (6.67%)

1 (1.18%)

P > 0.05

Bilateral

Unilateral

AR oVEMP ≥ 35%

22 (18.64%)

27 (18.0%)

15 (17.65%)

P > 0.05

AR cVEMP ≥ 35%

9 (7.63%)

18 (12.0%)

7 (8.24%)

P > 0.05

↓ **Table 4.** Comparisons of oVEMP and cVEMP Among the Three Groups
Parameters	Migraine (n = 118)	VM (n = 150)	TTH (n = 85)	P-value
1: migraine group, 2: VM group, 3: TTH group. latency, ms; AR VEMP, %; amplitude, mV. AR: asymmetry ratio; cVEMP: cervical vestibular evoked myogenic potential; l: left; oVEMP: ocular vestibular evoked myogenic potential; r: right; TTH: tension-type headache; VM: vestibular migraine.
oVEMP
AR oVEMP	22.61 ± 17.92	22.08 ± 17.55	19.65 ± 14.30	P > 0.05	P > 0.05	P > 0.05
r-n10 latency	10.88 ± 1.66	10.94 ± 1.44	11.22 ± 1.61	P > 0.05	P > 0.05	P > 0.05
r-p15 latency	14.87 ± 1.68	14.81 ± 1.61	14.94 ± 1.73	P > 0.05	P > 0.05	P > 0.05
r-interpeak	4.00 ± 0.97	3.87 ± 0.99	3.78 ± 0.92	P > 0.05	P > 0.05	P > 0.05
r-amplitude	2.51 ± 2.01	2.22 ± 2.01	2.22 ± 2.08	P > 0.05	P > 0.05	P > 0.05
l-n10 latency	11.01 ± 1.85	10.85 ± 1.62	11.13 ± 1.62	P > 0.05	P > 0.05	P > 0.05
l-p15 latency	14.92 ± 1.76	14.74 ± 1.66	14.94 ± 1.68	P > 0.05	P > 0.05	P > 0.05
l-interpeak	3.95 ± 0.96	3.89 ± 0.90	3.87 ± 0.90	P > 0.05	P > 0.05	P > 0.05
l-amplitude	2.40 ± 2.47	2.09 ± 2.17	1.88 ± 1.74	P > 0.05	P > 0.05	P > 0.05
cVEMP
AR cVEMP	14.64 ± 13.56	17.83 ± 13.53	14.21 ± 12.04	P = 0.05	P > 0.05	P < 0.05
r-p13 latency	15.27 ± 2.51	14.99 ± 2.98	14.24 ± 2.83	P > 0.05	P = 0.01	P < 0.05
r-n23 latency	20.25 ± 2.90	19.92 ± 3.14	19.01 ± 3.06	P > 0.05	P < 0.005	P < 0.05
r-interpeak	4.98 ± 2.14	4.98 ± 1.73	4.77 ± 1.78	P > 0.05	P < 0.005	P < 0.05
r-amplitude	25.75 ± 28.61	21.65 ± 20.68	20.27 ± 16.30	P > 0.05	P > 0.05	P > 0.05
l-p13 latency	15.32 ± 2.64	15.07 ± 2.62	15.34 ± 2.81	P > 0.05	P > 0.05	P > 0.05
l-n23 latency	20.40 ± 2.90	19.95 ± 2.95	19.91 ± 3.05	P > 0.05	P > 0.05	P > 0.05
l-interpeak	5.08 ± 1.95	4.88 ± 1.79	4.56 ± 1.63	P > 0.05	P < 0.05	P > 0.05
l-amplitude	28.35 ± 40.22	21.76 ± 19.94	20.90 ± 17.74	P > 0.05	P > 0.05	P > 0.05

↓ Table 4. Comparisons of oVEMP and cVEMP Among the Three Groups

Parameters

Migraine (n = 118)

VM (n = 150)

TTH (n = 85)

P-value

1 vs. 2

1 vs. 3

2 vs. 3

1: migraine group, 2: VM group, 3: TTH group. latency, ms; AR VEMP, %; amplitude, mV. AR: asymmetry ratio; cVEMP: cervical vestibular evoked myogenic potential; l: left; oVEMP: ocular vestibular evoked myogenic potential; r: right; TTH: tension-type headache; VM: vestibular migraine.

oVEMP

AR oVEMP

22.61 ± 17.92

22.08 ± 17.55

19.65 ± 14.30

P > 0.05

r-n10 latency

10.88 ± 1.66

10.94 ± 1.44

11.22 ± 1.61

P > 0.05

r-p15 latency

14.87 ± 1.68

14.81 ± 1.61

14.94 ± 1.73

P > 0.05

r-interpeak

4.00 ± 0.97

3.87 ± 0.99

3.78 ± 0.92

P > 0.05

r-amplitude

2.51 ± 2.01

2.22 ± 2.01

2.22 ± 2.08

P > 0.05

l-n10 latency

11.01 ± 1.85

10.85 ± 1.62

11.13 ± 1.62

P > 0.05

l-p15 latency

14.92 ± 1.76

14.74 ± 1.66

14.94 ± 1.68

P > 0.05

l-interpeak

3.95 ± 0.96

3.89 ± 0.90

3.87 ± 0.90

P > 0.05

l-amplitude

2.40 ± 2.47

2.09 ± 2.17

1.88 ± 1.74

P > 0.05

cVEMP

AR cVEMP

14.64 ± 13.56

17.83 ± 13.53

14.21 ± 12.04

P = 0.05

P > 0.05

P < 0.05

r-p13 latency

15.27 ± 2.51

14.99 ± 2.98

14.24 ± 2.83

P > 0.05

P = 0.01

P < 0.05

r-n23 latency

20.25 ± 2.90

19.92 ± 3.14

19.01 ± 3.06

P > 0.05

P < 0.005

P < 0.05

r-interpeak

4.98 ± 2.14

4.98 ± 1.73

4.77 ± 1.78

P > 0.05

P < 0.005

P < 0.05

r-amplitude

25.75 ± 28.61

21.65 ± 20.68

20.27 ± 16.30

P > 0.05

l-p13 latency

15.32 ± 2.64

15.07 ± 2.62

15.34 ± 2.81

P > 0.05

l-n23 latency

20.40 ± 2.90

19.95 ± 2.95

19.91 ± 3.05

P > 0.05

l-interpeak

5.08 ± 1.95

4.88 ± 1.79

4.56 ± 1.63

P > 0.05

P < 0.05

P > 0.05

l-amplitude

28.35 ± 40.22

21.76 ± 19.94

20.90 ± 17.74

P > 0.05