This study aimed to find biomarkers for assessing migrainous features, that is, migrainous headache, sensitivity to sound and light (phono- and photophobia) and visual aura in vestibular migraine (VM) patients.
A retrospective cohort study.
University hospital.
A total of 400 definitive VM patients were classified into four groups based on the number of migrainous features. Group A (n = 45) had one migrainous feature (migrainous headache). Group B (n = 70) had migrainous headache along with phono- and photophobia, while Group C (n = 55) had migrainous headache and visual aura. Those with all three migrainous features were categorised in Group D (n = 230). Another 40 healthy subjects were also enrolled for comparison.
All subjects underwent an inner ear test battery comprising audiometry, cervical, ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) and caloric tests.
Significant difference in mean age was observed in Group A when compared to Groups B-D, indicating that younger age might not be associated with the manifestation of all three migrainous features. No significant difference was observed among the four groups irrespective of gender and inner ear test battery. Via multivariate logistic regression, the oVEMP test (adjusted odds ratio, aOR = 2.60) was superior to the cVEMP test as a stronger indicator for the presence of phono- and photophobia. Conversely, the cVEMP test (aOR = 2.59) served as a stronger indicator for the presence of visual aura than the oVEMP test.
The oVEMP test may act as a biomarker for phono- and photophobia, whereas the cVEMP test shows a strong capacity to predict visual aura.

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