Why is vestibular migraine associated with many comorbidities?

Vestibular migraine (VM) is a usual trigger of episodic vertigo. Patients with VM often experience spinning, shaking, or unsteady sensations, which are usually also accompanied by photophobia, phonophobia, motor intolerance, and more. VM is often associated with a number of comorbidities.

Evaluation of cervical vestibular miogenic evoked potential and electrococleography in the diagnosis of vestibular migraine.

Objectives: Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.

Latent class analysis of migraine associated vestibular-auditory symptoms.

Objective: This study aimed to identify the potential subgroups of migraines based on the patterns of migraine associated symptoms, vestibular and auditory symptoms using latent class analysis and to explore their characteristics.

Method: A total of 555 patients with migraine participated in the study. Symptoms such as nausea, vomiting, photophobia, phonophobia, osmophobia, visual symptoms, vestibular symptoms (dizziness, vertigo), and auditory symptoms (tinnitus, hearing loss, aural fullness) were assessed.

Management of Migraine-Associated Vestibulocochlear Disorders.

Migraine is a chronic neurological disorder that frequently coexists with different vestibular and cochlear symptoms (sudden hearing loss, tinnitus, otalgia, aural fullness, hyperacusis, dizziness, imbalance, and vertigo) and disorders (recurrent benign positional vertigo, persistent postural perceptual dizziness, mal de debarquement, and Menière's disease). Despite evidence of an epidemiological association and similar pathophysiology between migraine and these vestibulocochlear disorders, patients suffering from migraine-related symptoms are usually underdiagnosed and undertreated. Current migraine treatment options have shown success in treating vestibulocochlear symptoms.

Will Vestibular Migraine Pathology Lead to Ischemic Changes in Brain Tissue in Later Age?

Migraine has been considered to be an episodic, multifactorial, neurovascular disorder without long-term consequences to the brain, although numerous studies have shown a possible association between vestibular migraine and ischemic changes in the brain. 3 Case based scenarios of previously diagnosed patients with vestibular migraine on treatment, associated  with clinical changes of ischemia, infarction and white matter lesions are reviewed and integrated with the results based on MRI study. There is a need for proper diagnosis to address the complaints and manage symptoms during acute attacks of vestibular migraine and prophylaxis.

[Cervicogenic vertigo].

The prevalence of cervical dizziness, still not recognized by the entire medical community, not only does not become less frequent, but even increases today. This phenomenon is facilitated by the widespread computerization of our lives and, in particular, the strain on the neck when working with portable electronic equipment. Despite the fact that criteria that reliably confirming the association of dizziness with cervical pathology have not yet been defined, experimental and clinical evidence of such an association continues to accumulate.

A preliminary trial of botulinum toxin type A in patients with vestibular migraine: A longitudinal fMRI study.

Objective: This study aims to investigate the efficacy of botulinum toxin type A (BTX-A) in the prophylactic management of vestibular migraine (VM) and to determine whether this treatment modulates intrinsic functional brain network.

Methods: Vestibular migraine patients ( = 20, mean age 45.4 years) who were resistant to conventional prophylactic therapies had BTX-A injection and rs-fMRI before and 2 months after the injection.

Association of white matter hyperintensities with migraine phenotypes and response to treatment.

Introduction: White matter hyperintensities (WMHs) are frequently found in migraineurs. However, their clinical significance and correlation to different migraine phenotypes and treatment responses are not well defined. The study aimed to examine the association of WMHs with migraine clinical patterns and treatment response.

Update on diagnosis and differential diagnosis of vestibular migraine.

Background: Vestibular migraine (VM) is considered the most common cause of spontaneous episodic vertigo and the second most common cause of vertigo. However, without a biomarker or a complete understanding of the pathophysiology, VM remains underrecognized and underdiagnosed. Therefore, definite diagnostic criteria are urgently needed.

Clinical features of definite vestibular migraine through the lens of central sensitization: a cross-sectional study.

Background: Vestibular migraine (VM) commonly causes episodic vertigo/dizziness; however, its clinical features are unknown. Based on the evidence that central sensitization is related to VM pathogenesis, we hypothesized that cutaneous allodynia is frequently associated with patients with VM compared with patients without VM. This study aims to (1) elucidate the clinical features of patients with VM and (2) evaluate whether patients with VM were more frequently associated with cutaneous allodynia than patients without VM.

Unraveling the Etiology of Pediatric Vertigo and Dizziness: A Tertiary Pediatric Center Experience.

: Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood-BPV). We aimed to provide the possible etiological background of vertigo and dizziness in Slovenian children. : A retrospective case series of pediatric vertigo and dizziness children referred to the tertiary pediatric otorhinolaryngology center from 2015 to 2020.

Prevalence, clinical profile, and diagnosis of pediatric dizziness in a tertiary care hospital.

Introduction: Pediatric dizziness is an uncommon complaint presenting to the Otolaryngology clinic. While the term dizziness may be used to describe any altered sensation of orientation to the environment which includes presyncope, light-headedness and ataxia, vertigo refers to a false sensation of motion of self or surroundings. Although a variety of etiologies are known to cause dizziness and vertigo, evaluation of this symptom becomes challenging in children who are unable to clearly explain what they experience, the provoking factors, associated symptoms and the duration of attacks.

Do we need to reconsider the classification of vestibular migraine?

: Vestibular migraine (VM) is a complex disease characterized by recurrent episodes of migraine associated with vertigo attacks that are observed in 1-3% of the general population. Given its high prevalence and the impact on the health system, it is important to characterize these patients, in order to offer an accurate diagnosis and a proper treatment. As the diagnosis of VM is based on clinical features, the study of potential biomarkers has gained more interest in the last years, to improve the precision in the diagnosis of this disease.

Recurrent vestibulopathy: are cVEMP, oVEMP and inner ear MRI useful to distinguish patients with Menière's disease and vestibular migraine?

Purpose: The aim of this study was to assess the rate of endolymphatic hydrops (EH) on MRI and the rate of otolithic dysfunction with cVEMP and oVEMP, in patients with recurrent vertigo such as Menière's disease (MD), vestibular migraine (VM) and vestibular Menière's disease (vMD).

Methods: In this retrospective study, we performed 3D-FLAIR sequences with delayed acquisition in 20 MD, 20 VM and 20 vMD patients. Each subject was then assessed for the presence of EH on MRI.

Clinical and demographic characteristics of children and adolescents with acute vertigo symptoms: A cross-sectional study.

Background/aim: Vertigo is one of the rarely diagnosed disorders during childhood due to insufficient description of the children regarding their experiences to the physicians. The clinical features of children and adolescents admitted by acute vertigo symptoms were investigated to elaborate the subject retrospectively.

Materials And Methods: BetweenJanuary 2017–July 2019, records of cases admitted with acute vertigo complaints to pediatric neurology were retrospectively examined.

Vestibular migraine without headache treated with lomerizine: A 35-year-old woman undiagnosed for 10 years.

A 35-year-old woman presented with recurrent vertigo without headache, which had persisted for 10 years. Detailed medical history revealed that she experienced hearing loss, tinnitus, nausea, photophobia, phonophobia, and slight discomfort in the head during vertigo attacks, which often led to absence from work. Based on the diagnostic criteria of the International Classification of Headache Disorders, third edition, she was diagnosed with vestibular migraine and was prescribed lomerizine, as prophylaxis.

Cinnarizine as an alternative recommendation for migraine prophylaxis: a narrative review.

Introduction: Despite the available prophylactic and acute drugs for migraine management, this disabling disorder remains undertreated especially among pediatrics. In this review, the authors aim at assessing the preventive role cinnarizine plays in treating migraine based on previously published studies.

Areas Covered: Randomized clinical trials, randomized controlled trials, non-randomized open-label trials, and retrospective studies concerning cinnarizine in migraine prevention in children and adults were reviewed.

Current Validated Medical Treatments: Pharmacologic Interventions.

The search for an effective medication that will eliminate tinnitus has a long history. Currently, no drugs exist that universally cure tinnitus. Pharmacologic interventions that have been investigated can be divided into those that attempt to eliminate the perception of tinnitus, and those that are designed to treat the negative comorbidities associated with tinnitus, thereby mitigating tinnitus' negative impact on quality of life.

Vestibular Migraine I: Mechanisms, Diagnosis, and Clinical Features.

Vestibular migraine (VM), also known as migrainous vertigo or migraine-associated vertigo, is characterized by recurrent vestibular attacks often accompanied by migraine headaches and other migraine symptoms. It is one of the most common presenting complaints to physicians in primary care, otolaryngology, and neurology. Epidemiologic data suggest that VM may affect 1 to 3% of the general population and 10 to 30% of patients seeking treatment for dizziness.

[Neurophysiological approaches to the diagnosis and treatment of vestibular disorders in migraine and epilepsy].

The review considers the results of domestic and foreign studies of modern neurophysiological diagnosis of vestibular disorders in migraine and epilepsy. Currently, there is a large number of physiological and clinical methods to evaluate the functions of the peripheral and central parts of the vestibular sensory system. However, among the tests, the samples for the assessment of the physiological state of horizontal semicircular canals and associated stem canals predominate.

Genetic Analysis of a Large Family with Migraine, Vertigo, and Motion Sickness.

Background: Migraine is a common disorder most typically presenting as headache and often associated with vertigo and motion sickness. It is a genetically complex condition with multiple genes ultimately contributing to the predisposition and development of this episodic neurological disorder. We identified a large American family of 29 individuals of which 17 members suffered from at least one of these disorders, migraine, vertigo, or motion sickness.

[Cervical vertigo - reality or fiction?].

The existence of cervical vertigo is still a question under debate. The basic hypothesis of the disease is that the abnormalities of the neck cause dizziness. The name itself is not accurate, as on the basis of the descriptions we cannot talk about true vertigo.

Vestibular Migraine: How to Sort it Out and What to Do About it.

Background: Vestibular migraine (VM) is the most common neurologic cause of vertigo in adults and results in significant utilization of health care resources, but remains under-recognized and underdiagnosed.

Evidence Acquisition: Review of literature in PubMed using the following terms: vestibular migraine, migraine-associated vertigo, vertiginous migraine, benign recurrent vertigo, migraine-associated dizziness, migraine, migraine treatment, Meniere disease (MD), vertebrobasilar ischemia (VBI), posterior circulation stroke, benign paroxysmal positional vertigo, and episodic-ataxia Type 2 (EA2).

Results: VM can manifest with a variety of vestibular symptoms, including spontaneous vertigo, triggered vertigo, positional vertigo, and head-motion dizziness.

Migraine Associated Vertigo.

This chapter is a brief overview of migraine associated vertigo (MAV), focusing on the points most relevant to the practicing clinician. We review the definition of MAV, theories regarding its underlying pathophysiology, clinical presentation, epidemiology, findings on physical examination and oto vestibular testing, differential diagnosis, management and prognosis.