From the Guidelines
Yes, dizziness can be a symptom of migraine, specifically vestibular migraine, which may mimic various causes of dizziness and vertigo, including transient episodic vertigo syndrome (t-EVS) 1.
Key Features of Vestibular Migraine
- Vestibular migraine often presents with associated headache and other migrainous features, such as photophobia, phonophobia, and visual aura 1.
- Imaging is not required to diagnose vestibular migraine, as the diagnosis is primarily clinical 1.
- The pathogenesis of migraine is believed to involve peripheral and central activation of the trigeminovascular system, with cortical spreading depression thought to be the underlying neurophysiological substrate of migraine aura 1.
Diagnosis and Management
- A comprehensive approach is needed for accurate diagnosis and evidence-based management of migraine, including patient-centric care and education to ensure treatment adherence and satisfaction 1.
- Treatments for migraine include acute and preventive medications, as well as non-pharmacological therapies, but misdiagnosis and under-treatment remain significant public health challenges 1.
- The diagnostic criteria for migraine and its subtypes, including vestibular migraine, are well established, and a thorough clinical evaluation is essential for accurate diagnosis and effective management 1.
From the Research
Dizziness as a Symptom of Migraine
- Dizziness is a common symptom that can be related to migraine in various ways, including causally, statistically, or by chance 2.
- Vestibular migraine is a condition where dizziness is conceptualized as a vestibular symptom caused by migraine, and it is considered the most common cause of spontaneous episodic vertigo 3, 4.
- Studies have shown that the prevalence of vertigo is increased in patients with migraine, and vice versa, patients presenting to a dizziness clinic have a history of migraine more often than would be expected by chance 4.
- The diagnosis of vestibular migraine is based on symptom-based criteria, including recurrent vestibular symptoms, migraine according to the criteria of the International Headache Society, and migrainous symptoms during the vertigo 5.
- Dizziness can also be a symptom of other conditions related to migraine, such as benign paroxysmal positional vertigo, Ménière's disease, and motion sickness 2, 4.
Characteristics of Dizziness in Migraine
- Dizziness in migraine can manifest as spontaneous or positional rotational vertigo or dizziness induced by head motion 5.
- The vertigo may occur without accompanying headache and may last from seconds to several weeks 5.
- Migraine-associated vertigo can be diagnosed according to specific criteria, including recurrent vestibular symptoms, migraine, and migrainous symptoms during the vertigo 5.
- The pathophysiology of migraine-associated vertigo is still not fully understood, but several hypotheses have been proposed, including cortical spreading depression, regional changes in brain perfusion, and release of neurotransmitters 5.