Vestibular migraine vs other migraine types. Connective tissue, autonomic and autoimmune differences

<h3>Intro</h3> Co-morbidities like depression, anxiety, obesity and other pain condition are frequent in migraine. We aimed to understand whether patients with vestibular migraine (VM) share comorbidities with chronic migraine (CM) patients. <h3>Methods</h3> Cross-sectional study as a service evaluation from February 2020 to July 2023. We compared Postural Orthostatic Tachycardia syndrome (POTS), Ehler-Danlos syndrome or hypermobility, and autoimmune conditions, including irritable bowel disease, hypothyroidism, asthma, rheumatoid arthritis, Raynaud’s, polyarteritis nodosa, antiphospholipid syndrome, lupus, giant cell arteritis, psoriatic arthritis, mixed connective tissue disease, Sjogren, sarcoidosis, vasculitis and pericarditis in VM and CM. We used a χ² test at <i>P</i> &lt; 0.05 with Bonferroni correction (SPSS 28). <h3>Results</h3> Of 525 cases, 185 had VM and 340 CM, and percentage of age and sex were similar. POTS (5.4% vs 2.4%, respectively, χ²=3.47, <i>P</i>=0.05), inflammatory conditions (35.7% vs 24.7%, χ²=7.06, <i>P</i>&lt;0.01) and hypermobility (4.4% vs 3.8%, χ²=0.07, NS) was more common in VM than CM patients. <h3>Discussion</h3> We found a higher proportion of POTS among patients with VM, in comparison with CM and the 0.1- 1% prevalence in the literature. Dysautonomia has been correlated with chronification of headache in patients with POTS and patients with VM may present an even more dysfunctional physiology, which could affect different organs.