Chronic Headache and Migraine
The diagnosis of vestibular migraine
Dr Sally Rosengren
Royal Price Alfred Hospital
Funded By Constance Mary Heidenrich and Michael Rogers Stirling Estates
Co-Investigators : Dr Mirium Welgampola
2013 Dr Sally Rosengren

PROJECT SUMMARY:

This project aims to improve the diagnosis of patients with vestibular migraine, a common and treatable cause of episodic vertigo. Vertigo is the illusion of movement and is a debilitating symptom of inner ear vestibular (balance) dysfunction. Vestibular migraine is a form of migraine in which patients experience recurring episodes of vertigo, which sometimes coincide with a migraine headache, an aura or sensitivity to sound or light. The diagnosis is seldom straightforward since episodes of vertigo can sometimes occur without an accompanying headache. Episodes can vary in character from true spinning, rocking or tilting sensations to light-headedness; symptom duration can range from seconds to days! Patients who seldom experience headaches find it impossible to believe that their vertigo results from “migraine”.

The duration of vertigo attacks can also vary greatly between other vestibular diseases. This means that depending on the duration of vertigo episodes, vestibular migraine can mimic several different inner ear disorders. For example, very short episodes lasting seconds can be difficult to distinguish from benign positioning vertigo, intermediate episodes lasting hours are similar to Meniere’s Disease and prolonged episodes lasting days can be confused with vestibular neuritis.

In this project, we will recruit patients with vestibular migraine based on the duration of their attacks and compare their vestibular function test results to those of the closest mimic. By using new, non-invasive tests of vestibular function that test all five parts of the vestibular system we will build a diagnostic profile that will help identify vestibular migraine by the pattern of clinical features and test results.

This research will reveal the commonalities and differences between vestibular migraine and other common vestibular diseases. Measurement of the function of each vestibular end-organ will provide a disease profile to enable easier recognition by clinicians and facilitate early initiation of treatment.

Progress Report