Epidemiology of vertigo,migraine and vestibular migraine |
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Authors: | T Lempert H Neuhauser |
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Institution: | (1) Dept. of Neurology, Schlosspark-Klinik, Heubnerweg 2, 14059 Berlin, Germany;(2) Vestibular Research Group, Charité, Berlin, Germany;(3) Robert Koch Institut, Dept. of Epidemiology, General Pape Str. 62–66, 12101 Berlin, Germany;(4) Vestibular Research Group, Charité, Berlin, Germany |
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Abstract: | Both migraine and vertigo are common in the general population with lifetime prevalences of about 16 % for migraine and 7
% for vertigo. Therefore, a concurrence of the two conditions can be expected in about 1.1 % of the general population by
chance alone. However, recent epidemiological evidence suggests that the actual comorbidity is higher, namely 3.2 %. This
can be explained by the fact that several dizziness and vertigo syndromes occur more frequently in migraineurs than in controls
including benign paroxysmal positional vertigo, Meniere’s disease, motion sickness, cerebellar disorders and anxiety syndromes
which may present with dizziness. In addition, there is increasing recognition of a syndrome called vestibular migraine (VM),
which is vertigo directly caused by migraine. VM affects more than 1 % of the general population, about 10 % of patients in
dizziness clinics and at least 9 % of patients in migraine clinics.
Clinically, VM presents with attacks of spontaneous or positional vertigo lasting seconds to days. Migrainous accompaniments
such as headache, phonophobia, photophobia or auras are common but not mandatory. Cochlear symptoms may be associated but
are mostly mild and non-progressive. During acute attacks one may find central spontaneous or positional nystagmus and, less
commonly, unilateral vestibular hypofunction. In the symptom-free interval, vestibular testing adds little to the diagnosis
as findings are mostly minor and non-specific. In the absence of controlled studies, treatment of VM is adopted from the migraine
sphere comprising avoidance of triggers, stress management as well as pharmacotherapy for acute attacks and prophylaxis. |
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Keywords: | migraine vestibular vertigo dizziness |
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