Time for more attention to migrainous vertigo?

Patients with migraine frequently have vestibular complaints, ranging from frank vertigo to less specific symptoms of dysequilibrium and head motion intolerance. Numerous studies have documented the association of migraine and vestibular symptoms.1-7⇓⇓⇓⇓⇓⇓ In this issue of Neurology , Neuhauser et al. rigorously reassess the association in three groups—200 patients with migraine presenting to a headache clinic, 200 dizzy patients presenting to a neuro-otology clinic, and a control population of 200 orthopedic inpatients hospitalized for problems unrelated to headache or dizziness.8 Their study is unique by virtue of a relatively large study population, use of International Headache Society (IHS) criteria to define migraine, a prospective design, and proposed new criteria to define “probable” and “definite” migrainous vertigo. The authors’ major findings include the following: 1) migraine was more common in dizziness clinic patients than in orthopedic controls, which supports a connection between migraine and vestibular dysfunction; 2) although many patients complained of episodic vertigo …