Abstract
Vertigo and migraine are commonly co-occurring problems. The diagnostic criteria for vestibular migraine have recently been updated in the International Classification of Headache Disorders, 3rd edition (beta version), which allow better detection of this under-recognized condition. In many cases, a diagnosis of vestibular migraine will be established based on a typical history of concurrent migraine headache, photophobia, and/or migraine aura with the vertigo. Certain mimickers, such as Ménière’s disease, likely exist on a pathophysiologic continuum with vestibular migraine. In our review, we provide an update on the salient literature regarding the diagnosis and management of this condition.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Lipton RB, Stewart WF, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41(7):646.
Hansen JM, Lipton RB, et al. Migraine headache is present in the aura phase: a prospective study. Neurology. 2012;79(20):2044.
Bisdorff A, Von Brevern M, Lempert T, et al. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19:1–13.
Drummond PD. Motion sickness and migraine: optokinetic stimulation increases scalp tenderness, pain sensitivity in the fingers and photophobia. Cephalalgia. 2002;22(2):117–24.
Jan MM, Camfield PR, et al. Vomiting after mild head injury is related to migraine. J Pediatr. 1997;130(1):134–7.
Neuhauser HK, Radtke A, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006;67(6):1028–33.
Cherchi M, Hain TC. Migraine associated vertigo. Otolaryngol Clin N Am. 2011;44:367–75.
Murdin L, Davies RA, Bronstein AM. Vertigo as a migraine trigger. Neurology. 2009;25:638–42.
Buisseret-Delmas C et al. Organisation of reciprocal connections between trigeminal and vestibular nuclei in the rat. J Comp Neurol. 1999;409:153–68.
Marano E et al. Trigeminal stimulation elicits a peripheral vestibular imbalance in migraine patients. Headache. 2005;45:325–31.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808. This contains diagnostic criteria for vestibular migraine as outlined in the appendices.
Cutrer FM, Smith JH. Human studies in the pathophysiology of migraine: genetics and functional neuroimaging. Headache. 2013;53(2):401–12.
Maniyar F et al. Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks. Brain. 2014;137(1):232–41.
Magis D et al. Pearls and pitfalls: electrophysiology for primary headaches. Cephalalgia. 2013;33(8):526–39.
Olesen J et al. The common migraine attack may not be initiated by cerebral ischaemia. Lancet. 1981;2(8244):438–40.
Amin FA et al. Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura: a cross-sectional study. Lancet Neurol. 2013;12(5):454–61.
Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246(10):883.
Obermann M, Wurthmann S, et al. Central vestibular system modulation in vestibular migraine. Cephalalgia. 2014;34:1053–61.
Russo A, Marcelli V, et al. Abnormal thalamic function in patients with vestibular migraine. Neurology. 2014;82(23):2120–6.
Shin JH, Kim YK, et al. Altered brain metabolism in vestibular migraine: comparison of interictal and ictal findings. Cephalalgia. 2014;34(1):58–67.
Ophoff RA, Terwindt GM, et al. Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4. Cell. 1996;87(3):543.
Jurkat-Rott K, Lerche H, et al. Hereditary channelopathies in neurology. Adv Exp Med Biol. 2010;686:305–34.
Neuhauser H, Leopold M, et al. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436.
Thompson TL, Amedee R. Vertigo: a review of common peripheral and central vestibular disorders. Ochsner J. 2009;9(1):20–6.
Radtke A, Neuheuser H, Von Brevern M, et al. Vestibular migraine: validity of clinical diagnostic criteria. Cephalalgia. 2011;31:906–13.
Eggers SDZ, Staab JP, Neff BA, et al. Investigation of the coherence of definite and probable vestibular migraine as distinct clinical entities. Otol Neurotol. 2011;32:1144–51.
Radtke A et al. Vestibular migraine: long-term follow-up of clinical symptoms and vestibulo-cochlear findings. Neurology. 2012;79(15):1607–14. A prospective cohort study of patients with vestibular migraine, describing audiovestibular and other clinical outcomes.
Bikhazi P, Jackson C, Ruckenstein MJ. Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness. Am J Otol. 1997;18(3):350.
Johnson GD. Medical management of migraine-related dizziness and vertigo. Laryngoscope. 1998;108(1 Pt 2):1.
Gode S, Celebisoy N, Kirazli T, et al. Clinical assessment of topiramate therapy in patients with migrainous vertigo. Headache. 2010;50(1):77–84. Epub 2009 Jul 27.
Lepcha A, Amalanathan S, et al. Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2013;29.
Bisdorff AR. Management of vestibular migraine. Ther Adv Neurol Disord. 2011;4(3):183–91.
Baloh RW. Neurotology of migraine. Headache. 1997;37(10):615.
Sargent EW. The challenge of vestibular migraine. Curr Opin Otolaryngol Head Neck Surg. 2013;21.
Tomanovic T, Bergenius J. Different types of dizziness in patients with peripheral vestibular diseases—their prevalence and relation to migraine. Acta Otolaryngol. 2010;130(9):1024–30.
Staab JP. Chronic subjective dizziness. Contin Lifelong Learn Neurol. 2012;18(5):1118–41. A comprehensive review of an important and poorly recognized comorbidity of vestibular migraine.
Staab JP, Ruckenstein MJ. Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope. 2003;113:1714.
Honaker JA, Gilbert JM, et al. Adverse effects of health anxiety on management of a patient with benign paroxysmal positional vertigo, vestibular migraine and chronic subjective dizziness. Am J Otolaryngol. 2013;34(5):592–5.
Compliance with Ethics Guidelines
Conflict of Interest
Arun Swaminathan and Jonathan H. Smith declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Headache
Rights and permissions
About this article
Cite this article
Swaminathan, A., Smith, J.H. Migraine and Vertigo. Curr Neurol Neurosci Rep 15, 515 (2015). https://doi.org/10.1007/s11910-014-0515-z
Published:
DOI: https://doi.org/10.1007/s11910-014-0515-z