Peer Reviewed
Feature Article Neuropathic and neurological pain
Vertigo and migraine: ‘How can it be migraine if I don’t have a headache?’
Abstract
Vestibular migraine is a common, treatable cause of vertigo that should be considered whenever vertigo cannot be clearly explained by an alternative condition. In clinical practice, the patient’s response to treatment with a migraine preventive agent can determine the diagnosis.
Key Points
- Vestibular migraine is one of the most common causes of vertigo but the diagnosis is still controversial in some circles.
- Vestibular migraine is a protean disorder and should be considered whenever the clinical features of vertigo are not absolutely typical of an alternative diagnosis.
- Although there can be strong clinical clues pointing to it, vestibular migraine is a diagnosis of exclusion.
- If the patient presents with unilateral or asymmetrical hearing loss or tinnitus then a diagnosis of vestibular migraine should be questioned.
- Treatment with a migraine preventive agent is usually effective and can determine the diagnosis.
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