Vestibular migraine in low- and lower-middle-income countries: A scoping review

Eric K Kim; Amina Seguya; May Htoo Thaw; Peggy Tahir; Eric J Formeister; Christopher J Waterworth; Ali F Jaffer

doi:10.1016/j.joto.2023.05.003

Vestibular migraine in low- and lower-middle-income countries: A scoping review

J Otol. 2023 Jul;18(3):173-184. doi: 10.1016/j.joto.2023.05.003. Epub 2023 May 18.

Authors

Eric K Kim^{1

2}, Amina Seguya^{1

3}, May Htoo Thaw^{1

4}, Peggy Tahir^{1

5}, Eric J Formeister^{1

6}, Christopher J Waterworth^{1

7

8}, Ali F Jaffer^{1

9}

Affiliations

¹ The Global Otolaryngology-Head and Neck Surgery Initiative, USA.
² Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, USA.
³ Ear, Nose and Throat Surgeon, Mulago National Referral Hospital, Kampala, Uganda.
⁴ Eye, ORL-HNS Hospital, Mandalay, Myanmar.
⁵ UCSF Library, University of California, San Francisco, CA, USA.
⁶ Department of Otolaryngology - Head and Neck Surgery, Duke University, Durham, NC, USA.
⁷ Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia.
⁸ Nossal Institute for Global Health, University of Melbourne, Victoria, Australia.
⁹ HearWell Audiology Clinic, Dar es Salaam, Tanzania.

Abstract

Background: Vestibular migraine (VM) is a common cause of dizziness that is underrecognized, underdiagnosed, and challenging to effectively treat. The prevalence, appropriate diagnostic workup, and therapies for VM in low- and lower-middle-income countries (LLMICs) remain understudied. The objective of this scoping review is to evaluate the current state of VM research in LLMICs.

Methods: PubMed, Embase, and Web of Science databases were searched to execute a scoping review of VM. Keywords "vestibular diseases" and "vertigo" were used in combination with terms referring to LLMICs as defined by the World Bank. Title and abstract screening, full-text review, and data collection were conducted by two authors independently.

Results: Twenty-six studies were included in the scoping review. Most studies were cross-sectional (57.7%) or case studies/series (23.1%) and were conducted in urban settings only (92.3%). Geographic distribution of studies was skewed, with 65.4% of articles originating from India. The prevalence of VM among clinic patients ranged from 0.3% to 33.3%. VM most frequently presented as headache, nausea and vomiting, and photophobia. Radiographic imaging, audiometry, and electronystagmography/videonystagmography were the three most commonly utilized diagnostic modalities in the dizziness workup. The most studied pharmacotherapies included calcium channel blockers, followed by beta-blockers and antiepileptics. Case studies and series discussed less common VM pharmacotherapies, such as ayurvedic medicine.

Conclusions: There is a need for more VM research in LLMICs, including innovative diagnostic approaches and therapies that can improve VM care globally. Equitable partnerships between LLMIC and high-income country researchers must expand vestibular research capacity and productivity in LLMICs.

Keywords: Global; Migraine; Otolaryngology; Scoping review; Vestibular migraine.

Publication types

Review