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://www.jocmr.org

Original Article

Volume 16, Number 2-3, March 2024, pages 63-74

Presence of Spontaneous Nystagmus, Benign Paroxysmal Positional Vertigo, and Tumarkin Fall in Patients With Primary Headache and Their Responses to Caloric and Video Head Impulse Tests

**Table 1.** Comparison of Mean Age and Sex Ratio
Group	n	Age (mean ± SD)	Median	Male, n (%)	Comparison between groups	P
SD: standard deviation; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	142	41.15 ± 15.69	38.00	42 (29.58%)	1 and 2	< 0.001	> 0.05
2. VM	226	47.95 ± 16.67	51.00	51 (22.57%)	1 and 3	< 0.001	> 0.05
3. TTH	140	54.41 ± 13.95	56.00	58 (41.43%)	2 and 3	< 0.05	< 0.01
Total	508	47.83 ± 16.42	51.00	151 (29.72%)

Table 1. Comparison of Mean Age and Sex Ratio

Group

Age (mean ± SD)

Median

Male, n (%)

Comparison between groups

Age (t)

Sex (χ²)

SD: standard deviation; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

142

41.15 ± 15.69

38.00

42 (29.58%)

1 and 2

< 0.001

> 0.05

2. VM

226

47.95 ± 16.67

51.00

51 (22.57%)

1 and 3

< 0.001

> 0.05

3. TTH

140

54.41 ± 13.95

56.00

58 (41.43%)

2 and 3

< 0.05

< 0.01

Total

508

47.83 ± 16.42

51.00

151 (29.72%)

**Table 2.** Comparison for Spontaneous Nystagmus, Drop Attack and BPPV
Group	n	Spontaneous nystagmus, n (%)	Drop attack, n (%)	BPPV, n (%)	Comparison between groups	P
BPPV: benign paroxysmal positional vertigo; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	142	3 (2.11%)	1 (0.70%)	4 (2.82%)	1 and 2	< 0.01	> 0.05	< 0.02
2. VM	226	22 (9.73)	6 (2.65%)	22 (9.73%)	1 and 3	> 0.05	> 0.05	> 0.05
3. TTH	140	4 (2.86%)	2 (1.43%)	2 (1.43%)	2 and 3	< 0.02	> 0.05	< 0.01
Total	508	29 (5.71%)	9 (1.77%)	28 (5.51%)

Table 2. Comparison for Spontaneous Nystagmus, Drop Attack and BPPV

Group

Spontaneous nystagmus, n (%)

Drop attack, n (%)

BPPV, n (%)

Comparison between groups

Nystagmus

Drop attack

BPPV

BPPV: benign paroxysmal positional vertigo; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

142

3 (2.11%)

1 (0.70%)

4 (2.82%)

1 and 2

< 0.01

> 0.05

< 0.02

2. VM

226

22 (9.73)

6 (2.65%)

22 (9.73%)

1 and 3

> 0.05

3. TTH

140

4 (2.86%)

2 (1.43%)

2 and 3

< 0.02

> 0.05

< 0.01

Total

508

29 (5.71%)

9 (1.77%)

28 (5.51%)

**Table 3.** Comparison of Patients of Defect, Intolerance and Bilateral Vestibulopathy
Group	n	Invalid, n (%)	BVP, n (%)	Intolerance, n (%)	Comparison between groups	P	Residual cases (n)
BVP: bilateral vestibulopathy; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	142	6 (4.23%)	16 (11.76%)	17 (12.5%)	1 and 2	> 0.05	> 0.05	103
2. VM	226	3 (1.33%)	35 (15.70%)	25 (11.21%)	1 and 3	> 0.05	> 0.05	162
3. TTH	140	2 (1.43%)	17 (12.32%)	12 (8.70%)	2 and 3	> 0.05	> 0.05	110
Total	508	11 (2.17%)	68 (13.68%)	54 (10.87%)				375

Table 3. Comparison of Patients of Defect, Intolerance and Bilateral Vestibulopathy

Group

Invalid, n (%)

BVP, n (%)

Intolerance, n (%)

Comparison between groups

Residual cases (n)

BVP

Intolerance

BVP: bilateral vestibulopathy; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

142

6 (4.23%)

16 (11.76%)

17 (12.5%)

1 and 2

> 0.05

103

2. VM

226

3 (1.33%)

35 (15.70%)

25 (11.21%)

1 and 3

> 0.05

162

3. TTH

140

2 (1.43%)

17 (12.32%)

12 (8.70%)

2 and 3

> 0.05

110

Total

508

11 (2.17%)

68 (13.68%)

54 (10.87%)

375

**Table 4.** Comparison of Cases With DP ≥ 30%
Group	n	DP ≥ 30%, n (%)	Comparison between groups	P
DP: directional preponderance; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	103	9 (8.74%)	1 and 2	> 0.05
2. VM	162	21 (12.96%)	1 and 3	> 0.05
3. TTH	110	9 (8.18%)	2 and 3	> 0.05

Table 4. Comparison of Cases With DP ≥ 30%

Group

DP ≥ 30%, n (%)

Comparison between groups

DP: directional preponderance; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

103

9 (8.74%)

1 and 2

> 0.05

2. VM

162

21 (12.96%)

1 and 3

> 0.05

3. TTH

110

9 (8.18%)

2 and 3

> 0.05

**Table 5.** Comparison of UW
Group	n	UW ≥ 25%, n (%)	Comparison between groups	P (χ² test)
UW: unilateral weakness; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	103	28 (26.80%)	1 and 2	< 0.005
2. VM	162	78 (47.92%)	1 and 3	> 0.05
3. TTH	110	39 (35.05%)	2 and 3	< 0.05

Table 5. Comparison of UW

Group

UW ≥ 25%, n (%)

Comparison between groups

P (χ² test)

UW: unilateral weakness; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

103

28 (26.80%)

1 and 2

< 0.005

2. VM

162

78 (47.92%)

1 and 3

> 0.05

3. TTH

110

39 (35.05%)

2 and 3

< 0.05

**Table 6.** Comparison of Ranked Data for UW Among Three Groups
Group	n	Grade 3, n (%)	Grade 4, n (%)	Comparison between groups	P
UW: unilateral weakness; TTH: tension-type headache; VM: vestibular migraine.
1. Migraine	103	26 (25.24%)	2 (1.94%)	1 and 2	< 0.05	< 0.01
2. VM	162	60 (37.04%)	17 (10.4%)	1 and 3	> 0.05	< 0.05
3. TTH	110	28 (25.45%)	9 (8.18%)	2 and 3	< 0.05	> 0.05

Table 6. Comparison of Ranked Data for UW Among Three Groups

Group

Grade 3, n (%)

Grade 4, n (%)

Comparison between groups

Grade 3

Grade 4

UW: unilateral weakness; TTH: tension-type headache; VM: vestibular migraine.

1. Migraine

103

26 (25.24%)

2 (1.94%)

1 and 2

< 0.05

< 0.01

2. VM

162

60 (37.04%)

17 (10.4%)

1 and 3

> 0.05

< 0.05

3. TTH

110

28 (25.45%)

9 (8.18%)

2 and 3

< 0.05

> 0.05

**Table 7.** Comparison of vHIT in Three Groups
Group	n	Abnormal vHIT, n (%)
P < 0.05, *P < 0.01 between group 1 and group 2. SCC: semicircular canal; vHIT: video head impulse test; VOR: vestibular ocular reflex.
1. Migraine	142	4 (2.82%)	2 (1.41%)	6 (4.23%)*	1 (0.70%)	7 (4.93%)**
2. VM	226	17 (7.52%)	8 (3.54%)	25 (11.06%)	5 (2.21%)	30 (13.27%)
3. TTH	140	6 (4.29%)	4 (2.86%)	10 (7.14%)	2 (1.43%)	12 (8.57%)

Table 7. Comparison of vHIT in Three Groups

Group

Abnormal vHIT, n (%)

Saccades of single SCC

Saccades of multiple SCC

Total of saccades

Reduced VOR gain

Sum of abnormal

*P < 0.05, **P < 0.01 between group 1 and group 2. SCC: semicircular canal; vHIT: video head impulse test; VOR: vestibular ocular reflex.

1. Migraine

142

4 (2.82%)

2 (1.41%)

6 (4.23%)*

1 (0.70%)

7 (4.93%)**

2. VM

226

17 (7.52%)

8 (3.54%)

25 (11.06%)

5 (2.21%)

30 (13.27%)

3. TTH

140

6 (4.29%)

4 (2.86%)

10 (7.14%)

2 (1.43%)

12 (8.57%)

**Table 8.** Comparison in Sensitivity of vHIT and Cal Test in the Same Group
Group	Abnormal vHIT	Abnormal UW	P
Cal: caloric; UW: unilateral weakness; TTH: tension-type headache; vHIT: video head impulse test; VM: vestibular migraine.
Migraine	142	4.93%	103	26.8%	< 0.001
VM	226	13.27%	162	47.92%	< 0.001
TTH	140	8.57%	110	35.05%	< 0.001

Table 8. Comparison in Sensitivity of vHIT and Cal Test in the Same Group

Group

Abnormal vHIT

Abnormal UW

UW ≥ 25%

Cal: caloric; UW: unilateral weakness; TTH: tension-type headache; vHIT: video head impulse test; VM: vestibular migraine.

Migraine

142

4.93%

103

26.8%

< 0.001

226

13.27%

162

47.92%

< 0.001

TTH

140

8.57%

110

35.05%

< 0.001