migraine-associated vertigo

migraine-associated vertigo

An idiopathic condition characterised by dizziness and/or recurrent vertigo (DRV) linked to migraines, and which is one the most common causes of chronic DRV. It is more common in females (1.5–5:1 ratio) and is more common in families. Many patients do not have headaches, or have chronic nonspecific headaches that do not fit into the International Headache Society’s migraine classification. Atypical Meniere's disease is now regarded as a migrainous vertigo syndrome.

Cllinical findings
Chronic dizziness and dysequilibrium, episodic rotational vertigo, chronic daily headaches, migraine headaches, light sensitivity, poor visual acuity and other changes in vision, visual "snow", nausea and severe motion intolerance. Because many of the symptoms cannot be objectively tested, physical and neurologic examinations and neuroimaging are often normal.

DiffDx
Meniere's disease, vestibular neuritis, psychiatric disorders.
References in periodicals archive ?
They address the clinical examination of the dizzy patient; imaging of the temporal bone; vestibular testing; the diagnosis and treatment of benign paroxysmal positional vertigo, Meniere's disease, vestibular neuritis, perilymphatic fistulas and superior semi-circular canal dehiscence syndrome, aminoglycoside vestibulotoxicity, posttraumatic dizziness, migraine-associated vertigo, and central vertigo disorders; vestibular rehabilitation; psychiatric and systemic disease implications; and special considerations for pediatric and elderly populations.
In BPPV it is usually less than a minute; in migraine-associated vertigo it can be from minutes to hours; in Meniere's disease a few hours; and in acute vestibular neuritis and consolidated brainstem stroke a few days.
In one of these reports, it is speculated that SSRIs may have treated associated morbidity such as migraine-associated vertigo or associated panic disease but not MD itself.
Nwaorgu, "Migraine-associated vertigo: a review of the pathophysiology and differential diagnosis," International Journal of Neuroscience, vol.
Otologic encounters (by site or disease): 17 ossicular abnormalities; 38 auricle; 145 external auditory canal; 39 foreign body in ear canal; 44 tympanic membrane; 54 middle ear infection, masses; 57 mastoid pathology; 93 hearing loss (conductive); 134 hearing loss (sensorineural); 33 hearing loss (mixed); 49 tinnitus; 26 Meniere syndrome; 15 migraine-associated vertigo; 77 vertigo; 91 balance complaints; 18 vestibular weakness; 40 benign paroxysmal postural vertigo; and 2 temporal bone fractures.
Various terms have been used to describe the relationship between migraine and vestibular symptoms including migrainous vertigo, migraine-associated vertigo or dizziness, migraine-related vestibulopathy, and benign recurrent vertigo [2-6].
Migraine-associated vertigo. Acta Otolaryngol 2005;125(3):276-9.
(4) Each patient was counseled by the lead author (T.E.B.), who explained the differential diagnoses and the progression of treatment from therapy for endolymphatic hydrops to therapy for migraine-associated vertigo. Patients were also given written educational materials.
Based on the results of these batteries of tests, we gave 46 patients (6.0%) a differential diagnosis of endolymphatic hydrops versus migraine-associated vertigo. (5) The history and physical examination of these patients did not suggest any of the proposed etiologies for endolymphatic hydrops (e.g., allergy or autoimmune processes), nor was the audiogram suggestive of classic Meniere's disease.
Six patients (26.1%) had not improved with treatment for endolymphatic hydrops but did subsequently experience an alleviation of symptoms after they had been referred to a neurologist and prescribed treatment for migraine-associated vertigo (MAV group).
The results of our study suggest that for patients who have an equivocal differential diagnosis of endolymphatic hydrops versus migraine-associated vertigo, a stepwise approach to treatment is appropriate.
For example, these trends suggest that patients with migraine-associated vertigo are younger and have much shorter vertigo attacks than those with endolymphatic hydrops.