Skip Navigation LinksHome > October 2013 - Volume 21 - Issue 5 > The challenge of vestibular migraine
Current Opinion in Otolaryngology & Head & Neck Surgery:
doi: 10.1097/MOO.0b013e3283648682
AUDITORY AND VESTIBULAR SCIENCE: Edited by Rodney C. Diaz

The challenge of vestibular migraine

Sargent, Eric W.

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Abstract

Purpose of review

Migraine is a common illness and migraine-related dizziness occurs in up to 3% of the population. Because the diagnosis is controversial and may be difficult, many patients go undiagnosed and untreated. This review summarizes current understanding of the taxonomy and diagnosis of vestibular migraine, the relation of vestibular migraine to labyrinthine disease, and the treatment of the condition in adults and children.

Recent findings

The categories of migraine accepted by the International Headache Society do not reflect the complex presentations of patients suspected of having vestibular migraine. In clinical practice and research, criteria are increasingly accepted that divide patients suspected of vestibular migraine into ‘definite vestibular migraine’ and ‘probable vestibular migraine.’ Because vertigo itself may trigger migraine, patients with vestibular migraine should be suspected of having vestibular end-organ disease until proven otherwise. Treatment remains controversial because of a notable lack of randomized controlled studies of vestibular migraine treatment.

Summary

For now, the best strategy for the treatment of suspected vestibular migraine patients is dietary/lifestyle modification, antinausea/antiemetics for acute vertigo, and preventive medication for patients who have continued disruptive symptoms. Patients with vestibular migraine should be monitored regularly for the development of latent audiovestibular end-organ disease.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

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