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Migraine and Motion Sensitivity

Furman, Joseph M. MD, PhD, FAAN; Marcus, Dawn A. MD

doi: 10.1212/01.CON.0000421621.18407.96
Review Articles

Purpose of Review: This article describes vestibular migraine and motion sensitivity. Migraine headache is often accompanied by dizziness or unsteadiness. A diagnosis of vestibular migraine requires that a patient meet International Headache Society criteria for migraine headache, have episodic or fluctuating symptoms highly suggestive of a balance disorder, have no recognized alternative neuro-otologic diagnosis, and experience migrainous symptoms during episodes of vertigo or imbalance. This article discusses these diagnostic criteria; the epidemiology of vestibular migraine; laboratory abnormalities in vestibular migraine; the pathophysiology of vestibular migraine; the treatment of vestibular migraine; comorbidities and overlap with other neuro-otologic disorders, including basilar artery migraine, Ménière disease, and anxiety disorders; and the genetics of vestibular migraine. This review also discusses motion sickness and motion sensitivity, including their relationship with migraine, pathophysiology, and treatment.

Recent Findings: Recent findings regarding vestibular migraine include new nomenclature for the disorder, validation of diagnostic criteria, new ideas regarding pathophysiology, and reviews of small treatment trials.

Summary: Vestibular migraine is becoming the preferred designation for a neuro-otologic disorder with a migrainous etiology that causes dizziness and disequilibrium. Criteria have been established for diagnosing this disorder. Although pathophysiology is as yet uncertain and randomized trials are lacking, treatment recommendations can be made. Motion sickness represents a condition often associated with migraine that can reduce quality of life.

Address correspondence to Dr Joseph M. Furman, University of Pittsburgh, Department of Otolaryngology, 200 Lothrop Street, Suite 500, Pittsburgh, PA 15213, furman@pitt.edu.

Relationship Disclosure: Dr Furman serves as the editor-in-chief of Journal of Vestibular Research; has performed personal injury medicolegal work; and has received a grant from the NIH. Dr Marcus has received personal compensation for freelance writing from MAP Pharmaceuticals, Inc., and has received a grant for migraine research from the Raymond and Elizabeth Bloch Educational and Charitable Foundation.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Furman and Marcus discuss the unlabeled use of medications for vestibular migraine. Notes regarding the limited supportive evidence for their efficacy are included where appropriate.

© 2012 American Academy of Neurology
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