Vestibular migraine

Vertigo and headache are the most frequently reported symptoms in clinical neurology. About 30% to 50% of all patients with migraine describe vertigo or dizziness associated with their migraine at least occasionally. The link between migraine and vertigo was described for the first time by Aretaeus of Cappadocia in 131 B.C. Systematic research of this association started at the end of the 19th century. This phenomenon was described with varying terminology and weighting in the literature and has come more and more into focus of clinical and scientific interest recently. Since 1990 the number of articles published in PubMed has doubled approximately every 5 years. The most common terms to describe the combination of both (migraine and vestibular symptoms) are vestibular migraine, migranous vertigo, migraine-associated vertigo, vertiginous migraine, migraine-associated balance disturbance and benign paroxysmal vertigo. Clear diagnostic criteria have been lacking for a long time and diagnosis was complicated by the complexity and abundance of associated symptoms. The International Headache Society (IHS), the Bárány-Society (International Society for Neuro-Otology), ENT physicians and other scientists have created a consensus document with consistent diagnostic criteria for vestibular migraine over the last few years which was published only last year and was considered in the appendix of the new ICHD-IIIbeta version of the headache classification. On the one hand these internationally accepted diagnostic criteria are intended to promote the systematic research of vestibular migraine. On the other hand they serve to create more certainty in diagnostic assessment and clinical managment of these patients in everyday clinical practice.