Vestibular migraine is the most frequent cause of episodic vertigo, as well as the second most frequent cause of vertigo in general. Dr. Aleman, ENT expert, discusses the relationship between vertigo and migraine.
Relationship between vertigo and migraine
A relationship between vertigo and migraine has long been established, obtaining various designations such as “migraine vertigo”, “migraine-associated vertibulopathy”, “migraine-associated vertigo” or “vertigo as a migraine equivalent”. In 2012, the Barany Society and the International Headache Society, two very important scientific societies, jointly established the precise diagnostic criteria. These societies included vestibular migraine in the International Classification of Hedache Disorders, which places vestibular migraine as a nosological entity recognized by neurologists and otoneurologists.
What is vestibular migraine?
This pathology is present in one out of every ten people who suffer from migraine, affecting these patients with episodic vertigo crises of variable duration, which can range from 5 minutes to 3 days. Episodes of crises include a spinning sensation or dizziness with head movements, as well as vertigo or dizziness triggered by complex visual environments or intense movement. These pictures are usually accompanied by symptoms that patients feel in a regular migraine. These symptoms can be headaches, photophobia, sonophobia or visual auras.
Diagnosis of vestibular migraine
The diagnosis of vestibular migraine is clinical, patients suffering from it must meet specific criteria to make the diagnosis. These criteria are established by the scientific societies mentioned above, but an adequate otoneurological and audiological examination must be carried out in order to rule out other pathologies. Sometimes specific instrumental vestibular studies are also required to rule out other vestibular pathologies that cause similar symptomatology, as well as to determine secondary alterations in the vestibular system that produce persistent symptomatology.
Treatment of vestibular migraine
The treatment applied depends on the severity of the process, usually with medications also used for migraine. On many occasions this pathology involves stress and anxiety secondary to the whole process and some patients require cognitive-behavioral psychological support, something that will help them to better manage the associated psychological alterations. It should also be taken into account that many patients with vestibular migraine present kinetosis, which consists of hypersensitivity to movement and all stimuli related to dizziness, something that significantly aggravates the symptomatology.