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Semin Neurol 2010; 30(2): 167-174
DOI: 10.1055/s-0030-1249225
© Thieme Medical Publishers

Migraine-Associated Vertigo: Diagnosis and Treatment

Yoon-Hee Cha1
  • 1Department of Neurology, University of California Los Angeles, Los Angeles, California
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Publication History

Publication Date:
29 March 2010 (online)

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ABSTRACT

Migraine-associated vertigo has become a well-recognized disease entity diagnosed based on a clinical history of recurrent vertigo attacks unexplained by other central or peripheral otologic abnormalities, which occurs in the patient with a history of migraine headaches. There is no international agreement on what spectrum of symptoms should be covered under this diagnosis, or what terminology should be used. The headaches and vestibular symptoms of migraine-associated vertigo may not be temporally associated, which often obscures the association. Diagnostic tests usually show nonspecific abnormalities that are also seen in patients with migraine who do not experience vestibular symptoms. Management generally follows the recommended treatment of migraine headaches, and includes dietary and lifestyle modifications and medical treatment with β blockers, calcium channel blockers, and tricyclic amines. Small case series show that acetazolamide and lamotrigine appear to be more effective for the vertigo attacks than headaches. Vestibular rehabilitation has also been shown to be helpful in several studies. In this review, the epidemiologic and clinical features of the disorder, as well as the current state of knowledge on pathophysiology, diagnostic testing, and treatment are described.

KEYWORDS

Migraine - vertigo - vestibular - dizziness

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Yoon-Hee ChaM.D. 

Visiting Assistant Professor, Department of Neurology, University of California Los Angeles

710 Westwood Plaza, Box 951769, Los Angeles, CA 90095

Email: yhcha@mednet.ucla.edu

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