Migraine is one of the most common cause of headache. Patients with migraine suffer from recurrent attacks of half or both sides of the head. The characteristic episodes of migraine are of throbbing in nature, associated with nausea and or vomiting, irritation of light, sounds, smell and aggravating on movements. These features may not be present or mandatory in every attack. The characteristics may differ in different attack in the same patient. Thus each patient with migraine has unique way of presentation with respect to the age of onset, triggers, duration of attacks, frequency of attacks, severity of attacks, location of headache and associated symptoms. Considering so much variations in the presentation, we can go further and say, ‘each patient with migraine on this planet is variant in itself’.
Vestibular migraine (VM) is one such form of migraine which presents with episodes of vertigo or dizziness. It is the most common cause of Vertigo or dizziness worldwide. It accounts for 7% of patients seen in dizziness clinics and 9% of patients seen in migraine clinics.
Vestibular migraine is the most common cause of the vertigo in Dubai population. In our experience at the dedicated Vertigo clinic, Aster Gardens specialty clinic, Discovery Gardens, Dubai, we found that the vestibular migraine constituted 46% of the patients who presented with Vertigo and dizziness. Please see the diagram below to see the spectrum of patients suffering of vertigo disorders from the data maintained at our clinic.
Giddiness in vestibular migraine can be felt in the form of spinning of surroundings or internal spinning of head, unsteadiness, blurry vision, sudden episodes on turning head quickly, difficulty in focusing and concentrating at the electronic screens, difficulty in scrolling the mobile phones. Many patients have a combination of these symptoms.
The patient with migraine can present with Vertigo alone, headache alone or both the symptoms together. Thus, the Vertigo and headache are the two sides of the same coin i.e. Vestibular migraine.
There is need to increase the awareness about this condition among the patients. The vertigo due to vestibular migraine is completely treatable with proper treatment of underlying migraine.