Vestibular migraine weird symptoms
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Unusual Symptoms of Vestibular Migraine
Introduction to Vestibular Migraine
Vestibular migraine (VM), also known as migrainous vertigo or migraine-associated vertigo, is a condition characterized by recurrent episodes of vertigo in individuals with a history of migraine. It is a common complaint in primary care, otolaryngology, and neurology settings, affecting approximately 1 to 3% of the general population and up to 30% of patients seeking treatment for dizziness . The condition is marked by a variety of symptoms, some of which are quite unusual and can complicate diagnosis and treatment.
Common and Uncommon Symptoms
Vertigo and Dizziness
The hallmark of vestibular migraine is vertigo, which can be spontaneous or positional, and may last from seconds to days 24. This vertigo is often accompanied by dizziness and balance disturbances, which can be more distressing than the migraine headache itself .
Sensory Sensitivities
Patients with vestibular migraine frequently experience heightened sensitivity to sensory stimuli. Phonophobia (sensitivity to sound) and photophobia (sensitivity to light) are common, mirroring the sensory sensitivities seen in typical migraine attacks 12. Additionally, osmophobia (sensitivity to smells) and kinesiophobia (fear of movement) are also reported, particularly in patients with migraine with aura .
Auditory Symptoms
Vestibular migraine can also present with a range of auditory symptoms. Tinnitus (ringing in the ears), hearing loss, aural fullness (a feeling of fullness in the ear), and otalgia (ear pain) are frequently associated with the condition 37. These symptoms can sometimes occur without vertigo, a condition referred to as cochlear migraine .
Motion Sickness and Nausea
Motion sickness is a prevalent symptom in vestibular migraine, often accompanied by nausea and vomiting. These symptoms are particularly pronounced in patients with migraine with aura . The motion sickness can be triggered by head movements or visual stimuli, leading to significant discomfort and disability 27.
Visual Vertigo
Visual vertigo, a sensation of dizziness triggered by visual stimuli, is another unusual symptom of vestibular migraine. This can include discomfort when looking at moving objects or patterns, and can significantly impact daily activities .
Overlapping Conditions
Vestibular migraine symptoms often overlap with other vestibular disorders, such as Meniere's disease and benign paroxysmal positional vertigo (BPPV). This overlap can complicate diagnosis and requires careful exclusion of other conditions 69.
Pathophysiology and Diagnosis
The exact pathophysiology of vestibular migraine remains unclear, but it is believed to involve interactions between the trigeminal and vestibular systems 24. Diagnosis is based on clinical criteria, including a history of migraine, the temporal association of vestibular and migraine symptoms, and the exclusion of other causes . Diagnostic challenges arise due to the variability in symptom presentation and the overlap with other vestibular disorders .
Conclusion
Vestibular migraine is a complex condition with a wide range of symptoms, some of which are quite unusual and can complicate diagnosis and treatment. Understanding the full spectrum of symptoms, including vertigo, sensory sensitivities, auditory symptoms, motion sickness, and visual vertigo, is crucial for accurate diagnosis and effective management. Further research is needed to better understand the pathophysiology of vestibular migraine and to develop targeted treatments.
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