Case presentation History: A 31-year-old woman presented with complaints of persistent postural imbalance for two weeks. [irispublishers.com]

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]

For example, babies may present with migraine in the form of “cyclical vomiting”. [menieres.org.uk]

Patients with VM also have high rates of chronic subjective dizziness, which may be associated with anxious, introverted temperaments that can affect clinical presentation and treatment response. [mayoclinic.pure.elsevier.com]

• 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]

• 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]

• 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]

• Flushing

  Vestibular migraine typically is associated with nausea, vomiting, sweating, flushing, diarrhoea and visual changes such as blurring, flashing lights and difficulty focussing. [menieres.org.uk]

• Vertigo

  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]

  […] description of vertigo. [reliasmedia.com]

  The mean vertigo intensity before nVNS was 5.2 (±1.6; median 6), and 3.1 (±2.2; median 3) following stimulation; mean reduction in vertigo intensity was 46.9% (±31.5; median 45%). [n.neurology.org]

  It should then not seem strange that vertigo may occur without headache. Two relatively common forms of migraine-associated vertigo seem to occur. Benign Paroxysmal Vertigo of childhood may be seen in children as young as age 2. [tampabayhearing.com]

  […] or Migrainous Vertigo. [irispublishers.com]

• Insomnia

  Psychiatric comorbidities include anxiety (92/131 [70.2%] patients), depression (53/131 [40.5%] patients), insomnia (38/131 [29.0%] patients), phobic disorders (15/131 [11.5%] patients), and psychogenic disorders (11/131 [8.4%] patients). [headachejournal.onlinelibrary.wiley.com]

  Among psychiatric comorbidities, 92 (70.2%) patients had anxiety, 52 (40.5%) had depression, 38 (26.0%) had insomnia, 15 (11.5%) were affected by phobic disorders, and 11 (8.4%) had psychogenic disorders. [clinicalpainadvisor.com]

  Anxiety (70%) and other psychiatric comorbidities were common: depression (40%), insomnia (29%), phobias (11%), and psychogenic disorders (8%). [reliasmedia.com]

  Additionally, 26% had insomnia. It is difficult to tell if these are comorbidities that existed prior to the migraine attacks, if the attacks brought them to the surface, or if the attacks caused them. [axonoptics.com]

• 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]

• Dyslipidemia

  Study of lipidic profile and prevalence of dyslipidemias in adult. Rev Bras Anal Clin. 2008;40:317-20. [ Links ] 22. Viana MC, Andrade LH. [scielo.br]

  […] history of ear discharge, otosclerosis, history of head or ear trauma, presence of systemic or metabolic diseases associated with hearing loss (as renal insufficiency, gout, diabetes mellitus, hypertension, ischemic heart disease, hypercholesterolemia/dyslipidemia [jneuro.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,” 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]

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. [journals.sagepub.com]

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]

[…] trial., 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]

A growing body of clinical and epidemiological evidence supports a specific relationship between vestibular symptoms and migraine. [mayoclinic.pure.elsevier.com]

Epidemiology and comorbidity of headache. Lancet Neurol. 2008;7:354-61. [ Links ] 17. International Association for the Study of Pain 2011 Annual Report. Migraine and hormonal changes. [scielo.br]

"Epidemiology of vertigo, migraine and vestibular migraine". J. Neurol. 256 (3): 333–8. doi : 10.1007/s00415-009-0149-2. PMID 19225823. ^ Cal R, Bahmad Jr F (2008). "Migraine associated with auditory-vestibular dysfunction" (PDF). [en.wikipedia.org]

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]

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]

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]

The following article will briefly review the pathophysiology of migraine, definition and criteria for diagnosing vestibular migraine and important points in taking a history for this population. [physiotherapy.ca]

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]

Vestibular migraine treatment and prevention. [reliasmedia.com]

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]

If you have frequent or disabling vestibular migraines, your doctor may try drugs similar to traditional migraine prevention meds. You take these regularly to reduce the severity or frequency of the headaches. [webmd.com]