Migrainous vertigo: development of a pathogenetic model and structured diagnostic interview

Abstract

An understanding of the relationship between migraine and the vestibular system increases knowledge of the pathogenesis of both migraine and vertigo. In addition, studies have identified successful treatment, with standard migraine therapies, of vestibular symptoms in patients with both migraine and vertigo. The use of a standardized assessment tool to identify this unique population of patients will help future studies to test both the pathological model and effective treatment options.

Vestibular migraine: diagnosis challenges and need for targeted treatment

“…In a population-based study, the prevalence of recurrent vertigo probably related to migraine was estimated at 2.8% in children with 6-12 years 17 . Vestibular migraine is diagnosed more often in children than adults (35% vs 6%) 8 . The most common cause of vertigo in children is benign paroxysmal vertigo, which has a strong association with a family history of migraine and may predict the development of typical migraine 18 .…”

“…However, detailed observation of this association was initiated only in the last 30 years. Since the first studies of Kayan et al about the vestibular manifestations of migraine 7 the number of articles addressing the relationship between vertigo and migraine has grown exponentially in the last 25 years 8,9 . Different terms have been used to designate the relationship of vertigo and migraine including migraine-associated vertigo, migraine-associated dizziness, migraine-related vestibulopathy, migrainous vertigo, benign recurrent vertigo.…”

Subjective Visual Vertical and Horizontal in Vestibular Migraine

“…Abnormal findings of central oculomotor and cerebellar functions in persons with migraine between the attacks of VM suggest subclinical continuous neuronal dysfunction in the brainstem and cerebellar nuclei [8] . A study focusing on the probable pathophysiological links between VM and vestibular mechanisms has proposed complex interactions involving the vestibular nuclei, trigeminal system, and thalamocortical pathways [9] .…”

The Role of Lifestyle Modifications in the Management of Migraine Associated Vertigo

“…The pathophysiology of MAV is not fully understood but both central and peripheral defects have been observed. The links between the vestibular nuclei, the trigeminal system, and thalamocortical processing centers provide the basis for the development of a pathophysiological model of MAV [7]. The headaches and vestibular symptoms of MAV may not be temporally associated [8].…”