Migraine associated dizziness symptoms
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Migraine-Associated Dizziness Symptoms
Prevalence of Dizziness and Vertigo in Migraine
Dizziness and vertigo are common symptoms associated with migraine, occurring both during the prodromal and headache phases. A systematic review and meta-analysis found that during the prodromal phase, 9.0% of individuals with migraine reported dizziness, while 3.3% reported vertigo. During the headache phase, the prevalence of dizziness ranged from 6.7% to 59.6%, and vertigo ranged from 6.4% to 44.7%1. This indicates that dizziness and vertigo are more frequent during the headache phase compared to the prodromal phase.
Diagnostic Challenges and Comorbid Conditions
Diagnosing vertigo and dizziness related to migraine can be challenging due to their varied presentations. Migrainous vertigo (MV) is a vestibular syndrome caused by migraine, presenting with spontaneous or positional vertigo lasting from seconds to days, often accompanied by migrainous symptoms2. Additionally, conditions like benign paroxysmal positional vertigo (BPPV) and Ménière's disease are statistically related to migraine, although the exact pathogenetic links remain unclear2. Patients with migraine also have a higher prevalence of motion sickness, orthostatic hypotension, anxiety disorders, and major depression, which can contribute to dizziness2.
Impact on Quality of Life
Dizziness significantly impacts the quality of life for individuals with migraine. A survey in Luxembourg found that 51.1% of participants with episodic headaches experienced dizziness, which was independently associated with greater headache-related disability, more severe depression, and higher overall disability4. This underscores the exacerbating effect of dizziness on the overall burden of migraine.
Management of Migraine-Associated Dizziness
Effective management of migraine-associated dizziness involves a combination of dietary changes, medication, and lifestyle adaptations. A retrospective chart review showed that 72% of patients experienced significant relief from vertigo or disequilibrium with these interventions3. Dietary manipulation alone provided significant relief for 100% of patients, while the addition of medications like tricyclic antidepressants, beta-blockers, or calcium-channel blockers further improved outcomes3. Another study highlighted that individualized treatment plans, including physical therapy and acupuncture, achieved substantial control of vestibular symptoms in a high percentage of patients5.
Special Considerations in Children and Adolescents
Migraine-related dizziness is also prevalent in children and adolescents. A study found that migraine-related vertigo (MRV) was the most common cause of dizziness in this age group, followed by combined migraine-related and somatoform vertigo (MSV)6. This highlights the importance of recognizing and managing these symptoms in younger populations to prevent long-term disability.
Conclusion
Dizziness and vertigo are significant symptoms associated with migraine, affecting a substantial proportion of individuals during both the prodromal and headache phases. These symptoms not only complicate the diagnosis but also exacerbate the overall burden of migraine. Effective management strategies, including dietary changes, medication, and lifestyle adaptations, can provide substantial relief. Recognizing and addressing these symptoms in both adults and children is crucial for improving quality of life and reducing disability associated with migraine.
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Most relevant research papers on this topic
Dizziness and vertigo during the prodromal phase and headache phase of migraine: A systematic review and meta-analysis
Dizziness and vertigo are more frequent during the headache phase of migraine compared to the prodromal phase, but more research is needed for accurate measurements.
Meta-Analysis
Rigorous JournalVertigo and Dizziness Related to Migraine: A Diagnostic Challenge
Vertigo and dizziness related to migraine can be caused by migraine, other disorders, or just by chance, making diagnosis challenging.
Highly CitedMigraine-associated Dizziness: Patient Characteristics and Management Options
Effective therapy, including dietary manipulation, medication, and neurology consultation, can significantly reduce migraine-associated dizziness symptoms.
Highly CitedHeadache-associated dizziness in a headache population: Prevalence and impact
Dizziness is a common accompanying symptom of headaches, particularly in migraines, and it exacerbates disability and depression, independent of visual symptoms.
Observational StudyMedical Management of Migraine‐Related Dizziness and Vertigo
Individualized treatment approaches, including dietary changes, medication, physical therapy, lifestyle adaptations, and acupuncture, effectively control migraine-related vestibular symptoms.
Highly CitedMigraine-Related Vertigo and Somatoform Vertigo Frequently Occur in Children and Are Often Associated
Migraine-related vertigo and somatoform vertigo are frequently associated in children, with somatoform vertigo being more prevalent in adolescents.
Observational StudyMigraine–anxiety related dizziness (MARD): a new disorder?
Migraine-anxiety related dizziness (MARD) is a new symptom complex that combines balance disorders, migraine, and anxiety, potentially leading to new treatment options for patients with dizziness.
Highly CitedEpidemiology of vertigo, migraine and vestibular migraine
The actual comorbidity between migraine and vertigo is higher than expected, with 3.2 % of the general population experiencing both conditions, and vestibular migraine, a condition directly caused by migraine, affecting more than 1 % of the general population.
Highly Cited