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Migraine and Vertigo

  • Headache (RB Halker, Section Editor)
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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.

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References

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  1. 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.

    Article  CAS  PubMed  Google Scholar 

  2. Hansen JM, Lipton RB, et al. Migraine headache is present in the aura phase: a prospective study. Neurology. 2012;79(20):2044.

    Article  PubMed Central  PubMed  Google Scholar 

  3. 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.

    PubMed  Google Scholar 

  4. Drummond PD. Motion sickness and migraine: optokinetic stimulation increases scalp tenderness, pain sensitivity in the fingers and photophobia. Cephalalgia. 2002;22(2):117–24.

    Article  CAS  PubMed  Google Scholar 

  5. Jan MM, Camfield PR, et al. Vomiting after mild head injury is related to migraine. J Pediatr. 1997;130(1):134–7.

    Article  CAS  PubMed  Google Scholar 

  6. Neuhauser HK, Radtke A, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006;67(6):1028–33.

    Article  CAS  PubMed  Google Scholar 

  7. Cherchi M, Hain TC. Migraine associated vertigo. Otolaryngol Clin N Am. 2011;44:367–75.

    Article  Google Scholar 

  8. Murdin L, Davies RA, Bronstein AM. Vertigo as a migraine trigger. Neurology. 2009;25:638–42.

    Article  Google Scholar 

  9. Buisseret-Delmas C et al. Organisation of reciprocal connections between trigeminal and vestibular nuclei in the rat. J Comp Neurol. 1999;409:153–68.

    Article  CAS  PubMed  Google Scholar 

  10. Marano E et al. Trigeminal stimulation elicits a peripheral vestibular imbalance in migraine patients. Headache. 2005;45:325–31.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. Cutrer FM, Smith JH. Human studies in the pathophysiology of migraine: genetics and functional neuroimaging. Headache. 2013;53(2):401–12.

    Article  PubMed  Google Scholar 

  13. Maniyar F et al. Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks. Brain. 2014;137(1):232–41.

    Article  PubMed  Google Scholar 

  14. Magis D et al. Pearls and pitfalls: electrophysiology for primary headaches. Cephalalgia. 2013;33(8):526–39.

    Article  PubMed  Google Scholar 

  15. Olesen J et al. The common migraine attack may not be initiated by cerebral ischaemia. Lancet. 1981;2(8244):438–40.

    Article  CAS  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246(10):883.

    Article  CAS  PubMed  Google Scholar 

  18. Obermann M, Wurthmann S, et al. Central vestibular system modulation in vestibular migraine. Cephalalgia. 2014;34:1053–61.

    Article  PubMed  Google Scholar 

  19. Russo A, Marcelli V, et al. Abnormal thalamic function in patients with vestibular migraine. Neurology. 2014;82(23):2120–6.

    Article  PubMed  Google Scholar 

  20. Shin JH, Kim YK, et al. Altered brain metabolism in vestibular migraine: comparison of interictal and ictal findings. Cephalalgia. 2014;34(1):58–67.

    Article  PubMed  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. Jurkat-Rott K, Lerche H, et al. Hereditary channelopathies in neurology. Adv Exp Med Biol. 2010;686:305–34.

    Article  PubMed  Google Scholar 

  23. Neuhauser H, Leopold M, et al. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436.

    Article  CAS  PubMed  Google Scholar 

  24. Thompson TL, Amedee R. Vertigo: a review of common peripheral and central vestibular disorders. Ochsner J. 2009;9(1):20–6.

    PubMed Central  PubMed  Google Scholar 

  25. Radtke A, Neuheuser H, Von Brevern M, et al. Vestibular migraine: validity of clinical diagnostic criteria. Cephalalgia. 2011;31:906–13.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  PubMed  Google Scholar 

  28. Bikhazi P, Jackson C, Ruckenstein MJ. Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness. Am J Otol. 1997;18(3):350.

    CAS  PubMed  Google Scholar 

  29. Johnson GD. Medical management of migraine-related dizziness and vertigo. Laryngoscope. 1998;108(1 Pt 2):1.

    Article  CAS  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. Lepcha A, Amalanathan S, et al. Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2013;29.

  32. Bisdorff AR. Management of vestibular migraine. Ther Adv Neurol Disord. 2011;4(3):183–91.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Baloh RW. Neurotology of migraine. Headache. 1997;37(10):615.

    Article  CAS  PubMed  Google Scholar 

  34. Sargent EW. The challenge of vestibular migraine. Curr Opin Otolaryngol Head Neck Surg. 2013;21.

  35. 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.

    Article  PubMed  Google Scholar 

  36. 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.

    Article  Google Scholar 

  37. Staab JP, Ruckenstein MJ. Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope. 2003;113:1714.

    Article  PubMed  Google Scholar 

  38. 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.

    Article  PubMed  Google Scholar 

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Arun Swaminathan and Jonathan H. Smith declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Jonathan H. Smith.

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This article is part of the Topical Collection on Headache

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Swaminathan, A., Smith, J.H. Migraine and Vertigo. Curr Neurol Neurosci Rep 15, 515 (2015). https://doi.org/10.1007/s11910-014-0515-z

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