Presentation
Case presentation History: A 31-year-old woman presented with complaints of persistent postural imbalance for two weeks. [irispublishers.com]
For example, babies may present with migraine in the form of “cyclical vomiting”. [menieres.org.uk]
With Hallpike-Dix positional testing (unless true BPPV presents), no rotational component nystagmus is usually evident. However in acute migraine event, bilateral torsional nystagmus may present with positional testing and gaze added. [vestibular.org]
Objective: The aim of this study is to characterize eye movements of patients presenting with nystagmus during attacks of migrainous vertigo. [karger.com]
If other migrainous features are present such as sensory sensitivity (to light, sound, smell, touch and movement), cognitive changes (memory loss, slowing of thoughts or brain function) or headache (head, neck or facial pain) are present then this should [nationalmigrainecentre.org.uk]
Entire Body System
-
Weight Gain
If quick relief is needed, a calcium antagonist (flunarizine or verapamil) is a good option, but be aware of sedation and weight gain. [ncbi.nlm.nih.gov]
-
Weight Loss
Many investigations of lifestyle modification on migraine include a single modification like diet, weight loss, or sleep. Our modifications include food triggers, restful sleep, exercise, and eating regularity. [clinicaltrials.gov]
-
Plethora
Such a multivariate analysis may be particularly helpful because there are a plethora of possible interactions between migraine and the vestibular system 9, so a heterogeneous set of mechanisms almost certainly contributes to the vestibular symptoms of [nature.com]
Gastrointestinal
-
Failure to Thrive
Our case is 14 months old, she was well until the age of three months when she started to have recurrent chest infection, abnormal movements as well as failure-to-thrive. [mathewsopenaccess.com]
Ears
-
Hyperacusis
These findings suggest altered pure tone temporal processing and mild level hyperacusis [ 11 ], respectively. [bmcneurol.biomedcentral.com]
Light, sound ( hyperacusis ) and odor sensitivity (hyperosmia). You may have some sensitivity daily and increased sensitivity when you have migraine. [balanceanddizziness.org]
Hyperacusis or excessive noise sensitivity is common in migraine, which may differentiate it from most ear disorders. Sensitivity to light (photophobia), especially during a migraine related event, is also commonly present. [tampabayhearing.com]
Audiometric testing in cases of migraine associated vertigo (MAV) typically reveals no changes in function other than occasional hyperacusis or noise sensitivity, which usually is temporary and resolves shortly after the migraine event ends. [vestibular.org]
Sensory amplification is very common -- Hyperacusis is common in migraine, which may differentiate it from most ear disorders. Sensitivity to light (photophobia) is also commonly present. [dizziness-and-balance.com]
-
Hearing Problem
Basic audiological examination ( table 2 ) revealed that few patients had evidence suggesting conduction hearing problems. Normal middle ear status was confirmed by otoscopy and standard aural immittance procedures. [jneuro.com]
-
Progressive Hearing Loss
Distinct from Meniere’s disease, significant progressive hearing loss or vestibular deficit are not a persistent feature in vestibular migraine. [acnr.co.uk]
-
Ear Discharge
Excluded were subjects with: previous history of otological or labyrinthine disorders, history of ear discharge, otosclerosis, history of head or ear trauma, presence of systemic or metabolic diseases associated with hearing loss (as renal insufficiency [jneuro.com]
Neurologic
-
Vertigo
[…] description of vertigo. [reliasmedia.com]
Overview Vestibular migraine presents with attacks of spontaneous or positional vertigo, head motion–induced vertigo, and visual vertigo lasting 5 minutes to 3 days. [medlink.com]
[…] or Migrainous Vertigo. [irispublishers.com]
The interrelations of migraine, vertigo, and migrainous vertigo. Neurology 2001;56:436-441. Murdin L, Davies RA, Bronstein AM. Vertigo as a migraine trigger. Neurology 2009;73:638-642. Baloh RW. Neurotology of migraine. Headache 1997;37:615-621. [acnr.co.uk]
-
Oscillopsia
The 2012 International Headache Society — Bárány Society definition of VM used for the diagnosis is essentially a migraine with vestibular symptoms such as vertigo, dizziness, visually induced or head-motion vertigo/dizziness, positional vertigo, oscillopsia [reliasmedia.com]
“Oscillopsia: Causes and Management.” Current Opinion in Neurology, U.S. National Library of Medicine, Feb. 2011, www.ncbi.nlm.nih.gov/pubmed/21102332. “Vestibular Migraine.” [axonoptics.com]
-
Gait Ataxia
ataxia, prominent auditory symptoms, and provocation by particular head movements point to other diagnoses Vestibular migraine adversely affects quality of life and increases the risk of falls. [bmj.com]
-
Recurrent Headache
Introduction Migraine is characterized by recurrent headache but more generally is considered a neurologic disorder of sensitization, as the headaches are characteristically associated with heightened sensitivity to light, sound, and other sensory stimuli [nature.com]
Treatment
“If these results can be confirmed with larger studies, not only could there finally be a treatment for vestibular migraine, such a treatment would also be easy to use,” said Beh. Reference Beh SC, Friedman DI. [ajmc.com]
“If these results can be confirmed with larger studies, not only could there finally be a treatment for vestibular migraine, such a treatment would also be easy to use.” [mdedge.com]
The questionnaires and scales that were applied to the patients before and after treatment were evaluated. [advancedotology.org]
Consequently, the treatment recommendations for the prophylactic treatment of vestibular migraine are mainly based on expert opinion and the treatments guidelines for migraine with and without aura. [touchneurology.com]
Prognosis
Prevalence, aetiologies and prognosis of the symptom dizziness in primary care – a systematic review. BMC Fam Pract 2018 ; 19: 33. DOI: 10.1186/s12875-017-0695-0. Google Scholar Crossref Medline 3. Newman-Toker, DE, Hsieh, Y-H, Camargo, CA, et al. [journals.sagepub.com]
Etiology
Episodic Vertigo – Differentiating the Possible Etiologies There are significant challenges in diagnosing vestibular migraine. [canadianaudiologist.ca]
Both have in common a multiplicity of etiologic causes as well as the need for an adequate symptomatic examination in order to make the correct diagnosis. [mathewsopenaccess.com]
"Our study highlights the close pathophysiologic relationship between migraine headache and vestibular migraine and supports the migrainous etiology of vestibular symptoms in this disorder," Beh continued. [medpagetoday.com]
Beh et al noted that the varied and somewhat bizarre nature of the complaint in patients with VM may seem to point to a purely psychiatric etiology and that, “It is therefore vital for neurologists to recognize the clues that can help them correctly diagnose [reliasmedia.com]
Neuhauser H,Radtke A,von Brevern M,Lempert T,, Neurology, 2003 Mar 11 [PubMed PMID: 12629256] [26] Evaluation of the efficacy of caffeine cessation, nortriptyline, and topiramate therapy in vestibular migraine and complex dizziness of unknown etiology [statpearls.com]
Epidemiology
A growing body of clinical and epidemiological evidence supports a specific relationship between vestibular symptoms and migraine. [mayoclinic.pure.elsevier.com]
OBJECTIVE: To analyze the clinical and epidemiological profile of patients with VM. METHODS: This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic. [scielo.br]
The epidemiology of vestibular migraine: a population-based survey study. Otol Neurotol 2018;39:1037–44. Murofushi T, Tsubota M, Kitao K, Yoshimura E. [canadianaudiologist.ca]
Meniere's disease: a 30-year epidemiologic and clinical study in Rochester, MN, 1951-1980. [dizziness-and-balance.com]
The link therefore was initially suspected on the basis of epidemiology. Migraine classically is a headache with or without aura though migraine related conditions can be diagnosed without headache. [irispublishers.com]
Pathophysiology
Without a biomarker or complete understanding of pathophysiology, diagnosis of vestibular migraine (VM) currently depends upon symptoms in two dimensions: episodic vestibular symptoms temporally related to migraine symptoms. [mayoclinic.pure.elsevier.com]
Firstly, we will describe the mechanisms of migraine itself, since current hypotheses are mostly based on its pathophysiology. Pathophysiology of Migraine Migraine is a complex disorder with a controversial pathophysiology. [frontiersin.org]
Self-motion perception is sensitized in vestibular migraine: pathophysiologic and clinical implications. Sci Rep. 2019;9(1):14323. [neurologyadvisor.com]
Common vestibular disorders in migraine Recurrent vertigo is most common in migraineurs and although this is frequently migrainous in origin, the high prevalence of vestibular disorders raises the question of overlapping pathophysiology. [acnr.co.uk]
The pathophysiology of vestibular migraine is unknown, but several mechanisms link the trigeminal system, which is activated during migraine attacks, and the vestibular system. [medlink.com]
Prevention
Objectives: To assess the effects of pharmacological agents for the prevention of vestibular migraine. [cochrane.org]
Preventative medications may be prescribed and these need to be taken every day whether or not you feel unwell. Migraine episode treatments may also be prescribed, including pain relief medication and anti-nausea medication. [eyeandear.org.au]
How to prevent Vestibular Migraine? In many VM patients, the attacks are severe, long and frequent enough to warrant a preventative migraine treatment. [migrainepal.com]
Vestibular migraine treatment and prevention. [reliasmedia.com]
Preventive medication is taken every day regardless of whether someone is having a migraine. Also, medication to relieve pain or nausea can help when an episode happens. [medicalnewstoday.com]