Vestibular migraine

### What you need to know A 63 year old woman presented to her general practitioner with episodes of severe dizziness, nausea, and vomiting associated with photophobia. On the first attack, symptoms were so severe she was admitted to hospital and underwent neuroimaging to exclude a stroke. Following recurrent episodes, she was given various diagnoses including benign paroxysmal positional vertigo and Ménière’s disease. She had a history of occasional episodic migraine but did not experience episodes of headache with dizziness. Eventually, a diagnosis of vestibular migraine was reached. After commencing topiramate, she has experienced no further attacks. Vestibular migraine (also known as migrainous vertigo) is considered a migraine variant, characterised by a combination of vertigo, dizziness, or balance disturbance with migrainous features. It is a relatively newly defined entity. In 2012, the Barany Society and International Headache Society released a consensus document on the diagnostic criteria, which has recently been included in the third edition of the International Classification of Headache Disorders (ICHD-3) (box 1). It is currently listed as an appendix, indicating the need for further validation with high level evidence, which may lead to its formal acceptance in future revisions.1 Despite this, we believe it is an important condition to be aware of and recognise, due to its high prevalence (see box 2) and the availability of effective treatments. Box 1 ### International Classification of Headache Disorders, third edition (ICHD-3) diagnostic criteria for vestibular migraine1 1. At … RETURN TO TEXT