Migraine-Associated Vertigo

Migraine is an extremely common condition worldwide, with 25-28 million people experiencing migraine in the United States alone. Migraine headaches are recurrent headaches often accompanied by light sensitivity and nausea separated by symptom-free intervals. The headaches are typically of a throbbing manner, are relieved by sleep, and can be accompanied by dizziness, visual symptoms, or vertigo. In some patients, the only symptom can be dizziness. Episodic vertigo associated with migraine has been reported in several syndromes including benign recurrent vertigo, benign paroxysmal vertigo, and Ménière disease. Several studies have shown a higher prevalence of migraine in patients presenting with vertigo compared to those without vertigo. The manifestation of migraine-associated vertigo can vary greatly, including episodic true vertigo, constant imbalance, positional vertigo, lightheadedness, and/or movement-associated disequilibrium. These symptoms can occur before or during a headache as well as during headache free intervals, which is most common. Due to this, many migraineurs experience dizziness or vertigo as their main symptom instead of headache. Episodic vertigo occurs in approximately 25-35% of all migraine patients, meaning that in the United States approximately 3.0-3.5% of people experience episodic vertigo and migraine.