Migraine and Vertigo

Migraine and vertigo are common disorders in medicine, affecting about 14–16% and 7–10%, respectively, of the general population. Recent epidemiologic studies indicate that 3.2% of the population have both migraine and vertigo. Vertigo may occur in up to 25% of patients with migraine. Migraine is the most frequent vascular disorder causing vertigo in all age groups. Migraine leads to various central or peripheral vestibular syndromes with vertigo such as migrainous vertigo, basilar-type migraine, benign paroxysmal vertigo of childhood, and other vertigo syndromes related to migraine. Migrainous vertigo is the most common cause of spontaneous recurrent vertigo. Diagnostic criteria for migrainous vertigo have been proposed but are not included in the most recent International Headache Society classification of migraine. On the other hand, there are statistical associations between migraine and vertigo syndromes including benign paroxysmal positional vertigo, Meniere's disease, persistent cerebellar symptoms, anxiety-related dizziness, and motion sickness. Vertigo can also act as a migraine trigger. Although some mutations in the CACNA1A gene have been identified in some familial cases, the mechanism of migraine-associated vertigo is still obscure. Treatment includes vestibular suppressants for acute attacks and migraine prophylaxis for patients with frequent attacks.