Did you know that vestibular migraine is now considered one of the most common vestibular Disorders??
It affects 1-2.7% of the general population and 11% of patients who attend a specialized dizziness clinic. (Shen et al 2020)
Vestibular migraine is a clinical syndrome of transient episodic vertigo/dizziness, or unsteadiness. It can last seconds to hours, in some cases lasting for several days. It includes features of temporary vestibular dysfunction such as nausea, dizziness, nystagmus, imbalance and at times falls.
Following a Vestibular migraine an individual may feel symptoms of fatigue, brain fog, poor concentration, imbalance, motion sensitivity, nausea, and in some instances have continuous light headedness.
30% of individuals with vestibular migraine will have no associated migraine before or after the episode of vertigo/dizziness.
Diagnostic criteria for Vestibular Migraine
A. At least five episodes of significant dizziness/vertigo lasting from minutes to days
B . A current or past history of migraine
C. At least half the episodes of vertigo have one or more migrainous feature associated with them such as typical migraine headache (one sided location, pulsating quality, moderate or server pain intensity, aggravation by routine physical activity, photophobia/photophonia, or visual aura)
D. Not better accounted for by another vestibular or headache diagnosis
(Simplified from the International Headache Society Classification of Headache ICHD-3-Feb 2018)
Treatment of vestibular migraine
Management of Vestibular migraine requires identification of the main triggers for the migraine, assessing for the vestibular and functional issues that arise due from the migraine, then taking a multi-modal approach to management, combining: