Headache
Vestibular Migraine
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Vestibular Migraine
Epidemiology
Incidence
: 1-2%
Very common diagnosis in neurotology (tertiary centers)
Common cause of episodic
Vertigo
in children
More common in women (by 3 fold over men)
Ages affected most commonly: 20 to 50 years old
Risk Factors
Family History
Diagnosis
Definitive Criteria
Current or previous history of
Migraine Headache
s (ICHD-II Criteria)
Vestibular symptom episodes at least 5 times
Vestibular symptoms of a least moderate severity lasting at least 1 minute
Episodes persists for no more than 72 hours
More than 50% of the attacks are accompanied by
Migraine
-type symptoms
Migraine Headache
Photophobia
Phonophobia
Visual aura
Management
See
Vertigo Management
Manage
Migraine Headache
s
Avoid
Migraine Headache Trigger
s
Avoid
Tyramine-Vasoactive Amines
Avoid excessive stress
Get adequate rest
Magnesium Supplementation
may be effective
Consider
Migraine Prophylaxis
(e.g.
Nortriptyline
,
Propranolol
,
Topiramate
)
Goal to reduce Vestibular Migraines by 50%
See
Migraine Headache Prophylaxis
References
Staab (2012) Mayo POIM Conference, Rochester
Muncie (2017) Am Fam Physician 95(3): 154-62 [PubMed]
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