Vestibular Migraine

  • Michael Thomas TeixidoEmail author
  • Mohammad Seyyedi


Vestibular migraine, a recently recognized entity, has transformed the care of the patients with dizziness. It is more common than benign paroxysmal positional vertigo and responds to well-established treatments developed for chronic migraine. Compared to neurologists and primary care physicians, otolaryngologists are less familiar with the treatment of migraine headaches, because it has not been included in their training curriculum. The term vestibular migraine refers to symptoms of dizziness and vertigo that can develop as a result of migraine mechanisms, which may cause dysfunction in the brainstem, at the cortex of the brain, or in the labyrinth itself.


Vestibular migraine Migraine-associated vertigo Migraine headache Migrainous vertigo 


  1. 1.
    Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S, Aydogan B. Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol. 1997;106(3):182–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Cutrer FM, Baloh RW. Migraine-associated dizziness. Headache. 1992;32(6):300–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246(10):883–92.CrossRefPubMedGoogle Scholar
  4. 4.
    Kayan A, Hood JD. Neuro-otological manifestations of migraine. Brain J Neurol. 1984;107(Pt 4):1123–42.CrossRefGoogle Scholar
  5. 5.
    Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436–41.CrossRefPubMedGoogle Scholar
  6. 6.
    Boenheim F. Über familiäre Hemicrania vestibularis. Neurol Centralbl. 1917;36:226–9.Google Scholar
  7. 7.
    Headache Classification Committee of the International Headache S. The international classification of headache disorders, 3rd edition (beta version). Cephalalgia Int J Headache. 2013;33(9):629–808.Google Scholar
  8. 8.
    Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F, Ziese T, et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology. 2006;67(6):1028–33.CrossRefPubMedGoogle Scholar
  9. 9.
    Russell MB, Rasmussen BK, Thorvaldsen P, Olesen J. Prevalence and sex-ratio of the subtypes of migraine. Int J Epidemiol. 1995;24(3):612–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Lance JW. Impact commentaries. Observations on 500 cases of migraine and allied vascular headache. J Neurol Neurosurg Psychiatry. 2012;83(7):673–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Selby G, Lance JW. Observations on 500 cases of migraine and allied vascular headache. J Neurol Neurosurg Psychiatry. 1960;23:23–32.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710–5.CrossRefGoogle Scholar
  13. 13.
    Alexander TH, Harris JP. Current epidemiology of Meniere’s syndrome. Otolaryngol Clin North Am. 2010;43(5):965–70.CrossRefPubMedGoogle Scholar
  14. 14.
    Sekitani T, Imate Y, Noguchi T, Inokuma T. Vestibular neuronitis: epidemiological survey by questionnaire in Japan. Acta Oto-laryngologica Supplementum. 1993;503:9–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Dieterich M, Obermann M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol. 2016;263:82–9.CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Batu ED, Anlar B, Topcu M, Turanli G, Aysun S. Vertigo in childhood: a retrospective series of 100 children. Eur J Paediatr Neurol: EJPN: Official J Eur Paediatr Neurol Soc. 2015;19(2):226–32.CrossRefGoogle Scholar
  17. 17.
    Jahn K, Langhagen T, Heinen F. Vertigo and dizziness in children. Curr Opin Neurol. 2015;28(1):78–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Furman JM, Balaban CD. Vestibular migraine. Ann N Y Acad Sci. 2015;1343:90–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Neff BA, Staab JP, Eggers SD, Carlson ML, Schmitt WR, Van Abel KM, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere’s disease, vestibular migraine, and Meniere’s disease with concomitant vestibular migraine. Otol Neurotology: Official Publ Am Otological Soc, Am Neurotol Soc [and] Eur Acad Otol Neurotology. 2012;33(7):1235–44.Google Scholar
  20. 20.
    Jeong SH, Oh SY, Kim HJ, Koo JW, Kim JS. Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness. J Neurol. 2010;257(6):905–12.CrossRefPubMedGoogle Scholar
  21. 21.
    Neugebauer H, Adrion C, Glaser M, Strupp M. Long-term changes of central ocular motor signs in patients with vestibular migraine. Eur Neurol. 2013;69(2):102–7.CrossRefPubMedGoogle Scholar
  22. 22.
    von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T. Acute migrainous vertigo: clinical and oculographic findings. Brain J Neurol. 2005;128(Pt 2):365–74.Google Scholar
  23. 23.
    Furman JM, Marcus DA. Migraine and motion sensitivity. Continuum. 2012;18(5 Neuro-otology):1102–17.Google Scholar
  24. 24.
    Baier B, Stieber N, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol. 2009;256(9):1447–54.CrossRefPubMedGoogle Scholar
  25. 25.
    Boldingh MI, Ljostad U, Mygland A, Monstad P. Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility. Cephalalgia Int J Headache. 2011;31(11):1211–9.CrossRefGoogle Scholar
  26. 26.
    King S, Wang J, Priesol AJ, Lewis RF. Central integration of canal and otolith signals is abnormal in vestibular migraine. Front Neurol. 2014;5:233.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Lewis RF, Priesol AJ, Nicoucar K, Lim K, Merfeld DM. Abnormal motion perception in vestibular migraine. The Laryngoscope. 2011;121(5):1124–5.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Lewis RF, Priesol AJ, Nicoucar K, Lim K, Merfeld DM. Dynamic tilt thresholds are reduced in vestibular migraine. J Vestib Res. 2011;21(6):323–30.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Dalkara T, Nozari A, Moskowitz MA. Migraine aura pathophysiology: the role of blood vessels and microembolisation. Lancet Neurol. 2010;9(3):309–17.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Pietrobon D, Moskowitz MA. Pathophysiology of migraine. Annu Rev Physiol. 2013;75:365–91.CrossRefPubMedGoogle Scholar
  31. 31.
    Bucher SF, Dieterich M, Wiesmann M, Weiss A, Zink R, Yousry TA, et al. Cerebral functional magnetic resonance imaging of vestibular, auditory, and nociceptive areas during galvanic stimulation. Ann Neurol. 1998;44(1):120–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Dieterich M, Brandt T. Functional brain imaging of peripheral and central vestibular disorders. Brain J Neurol. 2008;131(Pt 10):2538–52.CrossRefGoogle Scholar
  33. 33.
    Koo JW, Balaban CD. Serotonin-induced plasma extravasation in the murine inner ear: possible mechanism of migraine-associated inner ear dysfunction. Cephalalgia Int J Headache. 2006;26(11):1310–9.CrossRefGoogle Scholar
  34. 34.
    Moskowitz MA. Pathophysiology of headache–past and present. Headache. 2007;47(Suppl 1):S58–63.CrossRefPubMedGoogle Scholar
  35. 35.
    Vass Z, Shore SE, Nuttall AL, Miller JM. Direct evidence of trigeminal innervation of the cochlear blood vessels. Neuroscience. 1998;84(2):559–67.CrossRefPubMedGoogle Scholar
  36. 36.
    Ishiyama A, Jacobson KM, Baloh RW. Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol. 2000;109(4):377–80.CrossRefPubMedGoogle Scholar
  37. 37.
    Robbins LD. Management of headache and headache medications. 2nd ed. New York: Springer; 2000. xiv, 296 pp.Google Scholar
  38. 38.
    Mikulec AA, Faraji F, Kinsella LJ. Evaluation of the efficacy of caffeine cessation, nortriptyline, and topiramate therapy in vestibular migraine and complex dizziness of unknown etiology. Am J Otolaryngol. 2012;33(1):121–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Buchholz D. Heal your headache: the 1–2-3 program for taking charge of your headaches. Workman Press; 2002.Google Scholar
  40. 40.
    Martin VT, Taylor F, Gebhardt B, Tomaszewski M, Ellison JS, Martin GV, Levin L, et al. Allergy and immunotherapy: are they related to migraine headache? (1526–4610 (Electronic)).Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Christiana Care Health SystemWilmingtonUSA
  2. 2.Department of Otorhinolaryngology, Perleman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of OtolaryngologyThomas Jefferson Medical CollegePhiladelphiaUSA
  4. 4.Department of OtolaryngologyAugusta UniversityAugustaUSA

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