What is vertiginous migraine?

Updated: Oct 16, 2019
  • Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Growing evidence suggests that recurrent episodes of vertigo are related to migraine. [46, 71] Vertigo, a common complaint among migraineurs, has been reported in one third of cases. Recurrent episodes of vertigo lasting between 5 minutes and 1 hour—with or without nausea, vomiting, photophobia, or headache—in the setting of a previous personal history or a positive family history of migraine supports the diagnosis of vertiginous (vestibular) migraine. The pathophysiology of migraine-related vertigo is not fully understood. [72]

The differential diagnosis includes vertebrobasilar insufficiency and paroxysmal vestibular syndromes.

Patients with vertiginous migraine rarely respond to migraine prophylaxis. Anecdotal data are available on the benefits of the calcium channel blocker verapamil, and the tricyclic antidepressant amitriptyline; their anticholinergic properties may help control the vertigo.

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