We report a family with dominantly inherited migraine headaches, episo
dic vertigo, and essential tremor. All symptoms improved with the use
of acetazolamide. Linkage analysis ruled out linkage to markers on chr
omosome 19p, known to be linked to the genetic defect in families with
the clinically similar syndromes of hemiplegic migraine and periodic
ataxia. This genetic heterogeneity of migraine syndromes could result
from defects in a family of genes coding proteins with similar propert
ies.