Vestibular Migraine: Treatment and Prognosis

Michael von Brevern, MD; Thomas Lempert, MD


Semin Neurol. 2020;40(1):83-86. 

In This Article


Few studies have dealt with the prognosis of VM. A follow-up study at 9 years after initial diagnosis found that almost 90% of 61 patients still suffered from recurrent vertigo (mean age at follow-up: 55 years).[5] Frequency of vertigo was reduced in 56%, increased in 29%, and unchanged in 16%. All but one patient still had migraine headaches. Both cochlear symptoms during attacks (49%) and mild bilateral sensorineural hearing loss (18%) with a downsloping pattern on audiometry were more common on follow-up than at the initial presentation. Mild ocular motor abnormalities in the asymptomatic interval, including central positional nystagmus, defective smooth pursuit, and impaired vestibulo-ocular reflex suppression, become more common during the course of the disease.[5,41] Psychiatric disorders complicate the course of VM in more than 50% of patients and require individualized treatment.[36,42] Bilateral vestibulopathy may rarely develop in the course of VM.[43,44]