Vestibular migraine (VM) is a disorder with a spectrum of clinical presentations and among the most common causes of chronic vestibular symptoms. Some present with attacks before or during typical migraine, but many others have fluctuating or daily symptoms. While the symptoms and pathogenesis of vestibular migraine may have elements of both central and peripheral disorders, hearing loss should be absent. VM typically worsens with activity and head movements in general, and encompasses symptoms of vertigo, disequilibrium, or imbalance. While it is possible to confuse other disorders such as Meniere’s disease with migraine, it is worth making the diagnosis of vestibular migraine on clinical grounds after ruling out other possible causes. For acute attack treatment, migraine-specific medications such as triptans may be effective. In patients with frequent or disabling attacks, preventive treatment is essential. Vestibular rehabilitation may be helpful as well as medications used for migraine prevention such as including propranolol, venlafaxine, topiramate, and amitriptyline. For refractory patients, use of acetazolamide or lamotrigine may be reasonable.
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Conflict of Interest
Clinton G. Lauritsen has received honoraria from Cefaly Technology. Michael J. Marmura has received royalty payments from Cambridge, Devos Medical, and Medlink Neurology; salary support from Teva; and received compensation for consultations from Supernus.
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.
This article is part of the Topical Collection on Neurologic Ophthalmology and Otology
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Lauritsen, C.G., Marmura, M.J. Current Treatment Options: Vestibular Migraine. Curr Treat Options Neurol 19, 38 (2017). https://doi.org/10.1007/s11940-017-0476-z