A Review on the management of migraine associated vertigo

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Background: Migraine, a disorder classically characterized by episodic headache, may be associated with a variety of very different symptoms, and in the case of migraine associated vertigo (MAV), headache is not always present. A diagnosis of MAV is strongly suggested in patients with known migraine and normal hearing that present with vertigo attacks associated with headache and other migrainous symptoms.

Methods: This review was based on a literature search last performed on 30th November 2011. The MEDLINE, EMBASE and Cochrane databases were searched using the subject heading of migraine and vertigo in combination with diagnosis and treatment. These were limited to English language articles including clinical trials, meta-analyses, systematic reviews and review articles. Relevant references from selected articles were reviewed.

Results: Migraine has a lifelong prevalence of 12% and vertigo about 20–30%. Therefore, they might occur together just by chance. A thorough history is required to differentiate MAV from conditions such as Meniere’s disease, benign paroxysmal positional vertigo, vestibular neuronitis and episodic ataxia type 2 can mimic vestibular migraine that need to be further investigated. Physical examination of patients with vestibular migraine will usually be normal with normal hearing. Neurotological examination during acute attacks of MAV may provide diagnostic clues such as manifestation in some patients of central type spontaneous or positional nystagmus and occasionally peripheral vestibular loss. Vestibular testing in the symptom-free interval is often not rewarding as findings are usually mild and nonspecific.

Conclusion: The diagnosis and resulting management of MAV therefore requires a detailed history and physical examination to differentiate it from other causes of vertigo.

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Read 9544 times Last modified on Tuesday, 10 December 2013 14:21

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