Skip to main content
SpringerLink
Log in

Vestibular Migraine: Classification and Clinical Features

  • Chapter
  • First Online:
Vestibular Migraine and Related Syndromes

Abstract

Vestibular migraine is an increasingly recognized cause of recurrent vertigo. It may present at any age with attacks of spontaneous or positional vertigo, head motion-induced vertigo and visual vertigo lasting minutes to days. Since headache is often absent during acute attacks, other migrainous features such as photophobia, phonophobia or auras have to be specifically inquired about. The recent classification of vestibular migraine allows identification of vestibular migraine and probable vestibular migraine on the basis of explicit criteria. The diagnosis of VM is based on recurrent vestibular symptoms, a history of migraine, temporal association of vestibular symptoms with migraine symptoms and exclusion of other causes. Vestibular symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window between 5 min and 72 h. Common triggers include stress, sleep deprivation and hormonal changes. During acute attacks one may find central spontaneous or positional nystagmus and, less commonly, signs of unilateral vestibular hypofunction. In the asymptomatic interval, the neuro-otological examination is mostly normal. Some patients have mild ocular motor abnormalities including persistent positional nystagmus.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Liveing E (1873) On megrim: sick headache and some allied health disorders: a contribution to the pathology of nerve storms. Churchill, London, pp 129–148

    Google Scholar 

  2. Kayan A, Hood JD (1984) Neuro-otological manifestations of migraine. Brain 107:1123–1142

    Article  PubMed  Google Scholar 

  3. Behan PO, Carlin J (1982) Benign recurrent vertigo. Raven, New York

    Google Scholar 

  4. Cutrer FM, Baloh RW (1992) Migraine-associated dizziness. Headache 32:300–304

    Article  CAS  PubMed  Google Scholar 

  5. Cass SP, Ankerstjerne JKP, Yetiser S, Furman JM, Balaban C, Aydogan B (1997) Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol 106:182–189

    CAS  PubMed  Google Scholar 

  6. Johnson GD (1998) Medical management of migraine-related dizziness and vertigo. Laryngoscope 108:1–28

    Article  CAS  PubMed  Google Scholar 

  7. Dieterich M, Brandt T (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892

    Article  CAS  PubMed  Google Scholar 

  8. Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T (2001) The interrelations of migraine, vertigo, and migrainous vertigo. Neurology 56:436–441

    Article  CAS  PubMed  Google Scholar 

  9. Reploeg MD, Goebel JA (2002) Migraine-associated dizziness: patient characteristics and management options. Otol Neurotol 23:364–371

    Article  PubMed  Google Scholar 

  10. Brandt T, Strupp M (2006) Migraine and vertigo: classification, clinical features, and special treatment considerations. Headache Currents 3:12–19

    Article  Google Scholar 

  11. Lempert T, Olesen J, Furman J et al (2012) Vestibular migraine: diagnostic criteria. Consensus document of the Bárány Society and the International Headache Society. J Vestib Res 22:167–172

    PubMed  Google Scholar 

  12. International Headache Society Classification Subcommittee (2004) International classification of headache disorders. 2nd edition. Cephalalgia 24(Suppl 1):1–160

    Google Scholar 

  13. Sturzenegger MH, Meienberg O (1985) Basilar artery migraine: a follow-up study of 82 cases. Headache 25:408–415

    Article  CAS  PubMed  Google Scholar 

  14. Headache Classification Subcommittee of the International Headache Society (2013) The international classification of headache disorders: 3rd edition. Cephalalgia 33:629–808

    Article  Google Scholar 

  15. Bisdorff A, von Brevern M, Lempert T, Newman-Toker DE (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res 19:1–13

    PubMed  Google Scholar 

  16. Versino M, Sances G, Anghileri E et al (2003) Dizziness and migraine: a causal relationship? Funct Neurol 18:97–101

    PubMed  Google Scholar 

  17. Murdin L, Davies RA, Bronstein AM (2009) Vertigo as a migraine trigger. Neurology 73:638–642

    Article  PubMed  Google Scholar 

  18. Neuhauser HK, Radtke A, von Brevern M et al (2006) Migrainous vertigo. Prevalence and impact on quality of life. Neurology 67:1028–1033

    Article  CAS  PubMed  Google Scholar 

  19. Hsu LC, Wang SJ, Fuh JL (2011) Prevalence and impact of migrainous vertigo in midlife women. A community-based study. Cephalalgia 31:77–83

    Article  PubMed  Google Scholar 

  20. Geser R, Straumann D (2012) Referral and final diagnoses of patients assessed in an academic vertigo center. Front Neurol 3:Article 169. www.frontiersin.org

  21. Oh AK, Lee H, Jen JC, Baloh RW (2001) Familial benign recurrent vertigo. Am J Med Genet 100:287–291

    Article  CAS  PubMed  Google Scholar 

  22. Basser LS (1964) Benign paroxysmal vertigo of childhood (a variety of vestibular neuronitis). Brain 87:141–152

    Article  CAS  PubMed  Google Scholar 

  23. Krams B, Echenne B, Leydet J, Rivier F, Roubertie A (2011) Benign paroxysmal vertigo of childhood: long-term outcome. Cephalalgia 31:439–443

    Article  PubMed  Google Scholar 

  24. Abu-Arafeh I, Russell G (1995) Paroxysmal vertigo as a migraine equivalent in children: a population-based study. Cephalalgia 15:22–25

    Article  CAS  PubMed  Google Scholar 

  25. von Brevern M, Radtke A, Clarke AH, Lempert T (2004) Migrainous vertigo presenting as episodic positional vertigo. Neurology 62:469–472

    Article  Google Scholar 

  26. Kuritzky A, Ziegler DK, Hassanein R (1981) Vertigo, motion sickness and migraine. Headache 21:227–231

    Article  CAS  PubMed  Google Scholar 

  27. Waterston J (2004) Chronic migrainous vertigo. J Clin Neurosci 11:384–388

    Article  PubMed  Google Scholar 

  28. Jeong SH, Oh SY, Kim HJ et al (2010) Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness. J Neurol 257:905–912

    Article  PubMed  Google Scholar 

  29. Boldingh MI, Ljostadt U, Mygland A, Monstad P (2011) Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility. Cephalalgia 31:1211–1219

    Article  PubMed  Google Scholar 

  30. Eckhardt-Henn A, Best C, Bense S, Breuer P, Diener G, Tschan R, Dieterich M (2008) Psychiatric comorbidity in different organic vertigo syndromes. J Neurol 255:420–428

    Article  PubMed  Google Scholar 

  31. Furman JM, Balaban CD, Jacab RG, Marcus DA (2005) Migraine-anxiety related dizziness (MARD): a new disorder? J Neurol Neurosurg Psychiatry 76:1–8

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Yacovino DA, Hain TC (2013) Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol 33:244–255

    Article  PubMed  Google Scholar 

  33. Parker W (1991) Migraine and the vestibular system in adults. Am J Otol 12:25–34

    CAS  PubMed  Google Scholar 

  34. Neff BA, Staab JP, Eggers SD et al (2012) Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière’s disease, vestibular migraine and Ménière’s disease with concomitant vestibular migraine. Otol Neurotol 33:1235–1244

    Article  PubMed  Google Scholar 

  35. Radtke A, von Brevern M, Neuhauser H, Hottenrott T, Lempert T (2012) Vestibular migraine: long-term follow-up of clinical symptoms and vestibulo-cochlear findings. Neurology 79:1607–1614

    Article  PubMed  Google Scholar 

  36. Neugebauer H, Adrion C, Glaser M, Strupp M (2013) Long-term changes of central ocular motor signs in patients with vestibular migraine. Eur Neurol 69:102–107

    Article  PubMed  Google Scholar 

  37. Shin JE, Kim CH, Park HJ (2013) Vestibular abnormality in patients with Meniere disease and migrainous vertigo. Acta Otolaryngol 133:154–158

    Article  PubMed  Google Scholar 

  38. Vitkovic J, Paine M, Rance G (2008) Neuro-otological findings in patients with migraine- and nonmigraine-related dizziness. Audiol Neurootol 13:113–122

    Article  PubMed  Google Scholar 

  39. von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T (2005) Acute migrainous vertigo: clinical and oculographic findings. Brain 128:365–374

    Article  Google Scholar 

  40. Polensek SH, Tusa RJ (2009) Nystagmus during attacks of vestibular migraine: an aid in diagnosis. Audiol Neurootol 15:241–246

    Article  PubMed  Google Scholar 

  41. Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H (2002) Migraine and Menière’s disease: is there a link? Neurology 59:1700–1704

    Article  CAS  PubMed  Google Scholar 

  42. Cha YH, Brodsky J, Ishiyama G, Sabatti C, Baloh RW (2007) The relevance of migraine in patients with Meńière’s disease. Acta Otolaryngol 127:1241–1245

    Article  CAS  PubMed  Google Scholar 

  43. Cha YH, Kane MJ, Baloh RW (2008) Familial clustering of migraine, episodic vertigo, and Ménière’s disease. Otol Neurotol 29:93–96

    Article  PubMed Central  PubMed  Google Scholar 

  44. Radtke A, Neuhauser H, von Brevern M, Hottenrott T, Lempert T (2011) Vestibular migraine – validity of clinical diagnostic criteria. Cephalalgia 31:906–913

    Article  PubMed  Google Scholar 

  45. Brantberg K, Baloh RW (2011) Similarity of vertigo attacks due to Meniere’s disease and benign recurrent vertigo both with and without migraine. Acta Otolaryngol 131:722–727

    Article  PubMed  Google Scholar 

  46. American Academy of Otolaryngology - Head and Neck Foundation (1995) Committee on hearing and equilibrium: guidelines for the diagnosis and evaluation of therapy in Menière’s disease. Otolaryngol Head Neck Surg 113:181–185

    Article  Google Scholar 

  47. Best C, Tschan R, Eckhardt-Henn A, Dieterich M (2009) Who is at risk for ongoing dizziness and psychological strain after a vestibular disorder? Neuroscience 164:1579–1587

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Schlosspark-Klinik, Heubnerweg 2, Berlin, 12161, Germany

    Thomas Lempert

Authors
  1. Thomas Lempert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Lempert .

Editor information

Editors and Affiliations

  1. Dept of Neurology, San Raffaele Scientific Institute, Milano, Italy

    Bruno Colombo

  2. Dept of ENT, San Raffaele Scientific Institute, Milano, Italy

    Roberto Teggi

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Lempert, T. (2014). Vestibular Migraine: Classification and Clinical Features. In: Colombo, B., Teggi, R. (eds) Vestibular Migraine and Related Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-319-07022-3_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-07022-3_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07021-6

  • Online ISBN: 978-3-319-07022-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation