Verdigo as a migrainous symptom

Epidemiology: Since both migraine and vertigo are common complaints in clin ical practice they may coincide in an individual patient just by chalice. T here are, however, numerous patients with vestibular symptoms caused by mig raine, accounting for 6-8% of diagnoses in specialized dizziness clinics. Clinical Manifestation: Migraine-associated vertigo is a vestibular disorde r which manifests itself with spontaneous or positional rotational vertigo or dizziness induced by head motion. The vertigo may occur without accompan ying headache and may last from seconds to several weeks. Diagnosis: Migraine-associated vertigo can be diagnosed according to the fo llowing criteria: 1. recurrent vestibular symptoms, 2. migraine according t o the criteria of the International Headache Society, 3. migrainous symptom s during the vertigo such as headache, photophobia, phonophobia, scintillat ing scotoma or other auras, 4. exclusion of other causes. Pathophysiology: The mechanism of migraine-associated vertigo is still obsc ure. Several hypotheses relating to the pathophysiology of migraine have be en proposed: cortical spreading depression, regional changes in brain perfu sion, release of neurotransmitters and paroxysmal dysfunction of ion channe ls. Clinical findings suggest both central and peripheral vestibular involv ement. Therapy: Treatment is based on the repertoire of acute and prophylactic med ications that are used for migrainous headaches. Controlled studies on the treatment of migraine-associated vertigo are still lacking.