Migraine-related vertigo: Diagnosis and treatment |
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Authors: | Scott D Z Eggers |
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Institution: | (1) Department of Neurology, Mayo Clinic, 200 1st Street SW, 55905 Rochester, MN, USA |
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Abstract: | A comprehensive review of the neurotologic manifestations of migraine is presented, focusing on the most recent publications
regarding the epidemiology, clinical presentation, pathophysiology, diagnosis, and management of migraine-related vertigo
(MV). A strong association exists between vertigo and migraine, with MV being the most common cause of spontaneous (nonpositional)
episodic vertigo. Symptoms can be quite variable among patients and within individual patients over time, creating a diagnostic
challenge. MV generally presents with attacks of spontaneous or positional vertigo lasting seconds to days with associated
migrainous symptoms. Operational diagnostic criteria have been proposed but are not included in the most recent International
Headache Society classification of migraine. Better elucidation of the neurologic linkages between the central vestibular
pathways and migraine-related pathways and the discovery of ion channel defects underlying some causes of familial migraine,
ataxia, and vertigo have furthered the understanding of MV pathophysiology. Treatment of MV currently parallels that of migraine
headache, as proper studies of optimal MV management are just beginning. |
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