Familial Clustering of Migraine, Episodic Vertigo, and Ménière's Disease

Epidemiological and family studies support an association between migraine, episodic vertigo, and Meniere’s disease, but reports on detailed pedigrees are limited (1–9). Several childhood periodic symptoms not temporally associated with headache such as cyclical vomiting, abdominal migraines, and benign paroxysmal vertigo of childhood are recognized as precursors to the development of migraine headaches (10). This indicates that the susceptibility to migraine may manifest as these “migraine equivalents” during different periods of a person’s life. Episodic vertigo, for example, has been shown to occur as commonly as visual auras in migraine patients, often without associated headache (11–13). Aural symptoms and even fluctuating hearing loss has been noted in migraine patients raising the possibility that Meniere’s disease, in some patients, might be directly related to their susceptibility to migraine. If Meniere’s disease could develop as part of a spectrum of migraine-associated symptoms (perhaps as a “complication”), then one would expect to see combinations of migraine, Meniere’s disease, and Meniere’s-like symptoms run within families because there has been growing evidence that migraine has a strong genetic basis. To show the association between migraine, episodic vertigo, and Meniere’s disease, we report 6 families in which these syndromes were highly associated, indicating that there may be a pathophysiological link between them.