A link between migraine and vertigo was recognised over a hundred years ago, but the diagnostic entity vestibular migraine is relatively new. There is usually a prior history of migraine headaches with visual aura. The vertigo may be spinning or rocking. The duration of episodes is highly variable, lasting minutes, hours or days. Additional symptoms may be phonophobia, tinnitus and visual aura. The hearing does not fluctuate. The new diagnostic criteria by the Barany Society are:
At least 5 episodes with vestibular symptoms of moderate or intense severity, lasting 5 minutes to 72 hours;
Current or previous history of migraine with or without aura.
One or more migraine features with at least 50% of the episodes: headache with at least two of the following characteristics: one sided location, pulsating quality, moderate or severe pain intensity, aggravation by routine physical activity, photophobia and phonophobia, visual aura.
Vestibular migraine can be difficult to distinguish from Menière's disease.
- Assoc. Prof. Cynthia Darlington
Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, Bisdorff A, Versino M, Evers S, Newman-Toker D, 2012. Vestibular migraine: Diagnostic criteria. Journal of Vestibular Research 22(4):167-172.