Vestibular migraine
What is it?
Vestibular migraine is one of the most common vestibular disorders today, with an incidence of 2-3% in the general population. It is an episodic disorder of the vestibular system, characterised by the appearance of vestibular symptoms (vertigo, unsteadiness, nausea and/or vomiting). To make a diagnosis, 50% of vestibular episodes must be temporarily associated with a migraine headache (vestibular symptoms may precede, accompany or follow the headache) or with irritation to light and loud sounds (photophonophobia).
Which are the symptoms?
Typical symptoms of a vestibular migraine attack are varied and include: rotational vertigo crisis, subjective vertigo, positional vertigo, vertigo/unsteadiness triggered by visual stimuli of wide field of vision and/or head movement.
- Rotational vertigo
- Subjective vertigo
- Positional vertigo
- Instability/hypersensitivity to visual stimuli
How is it diagnosed?
Diagnosis is purely anamnestic and requires a clinical history of at least 5 episodes of vertigo in a patient with an established diagnosis of migraine (according to IHS criteria), lasting from 5 minutes to 72 hours, accompanied in at least 50% cases by photophobia and/or headache with migraine signs and/or visual aura.
- Collection of medical history
How is it treated?
Treatment is mainly aimed at preventing vertigo attacks with drugs (flunarizine, cinnarizine and dimenhydrinate, beta-blockers, calcium channel blockers, antiepileptics, antidepressants). Anti-inflammatory drugs and/or vestibulodepressants may be used (only for a short time and only for one episode of vertigo) in acute crises.
Where do we treat it?
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