title: Migrainous vertigo: development of a pathogenetic model and structured diagnostic interview.
abstract: OBJECTIVE
  Vestibular symptoms occur frequently in patients with migraine. This review refines recently proposed diagnostic criteria for migraine-related vestibular symptoms, and develops a pathophysiological model for the interface between migraine and the vestibular system.
  
  
  RESULTS
  The epidemiological link between migraine and vestibular symptoms and signs suggests shared pathogenetic mechanisms. Links between the vestibular nuclei, the trigeminal system, and thalamocortical processing centers provide the basis for the development of a pathophysiological model of migraine-related vertigo. During the last year, several studies have increased understanding of the relationship between migraine and vestibular symptoms. A study of motion sickness and allodynia in migraine patients supports the importance of central mechanisms of sensitization for migraine-related vestibular symptoms. A study has demonstrated effective treatment of vertigo with migraine therapy. The identification of migrainous vertigo, however, is hampered by a lack of standardized assessment criteria for both clinical and research practices. The application of published criteria for the diagnosis of migrainous vertigo allows the development of a standardized, structured assessment interview.
  
  
  CONCLUSIONS
  An understanding of the relationship between migraine and the vestibular system increases knowledge of the pathogenesis of both migraine and vertigo. In addition, studies have identified successful treatment, with standard migraine therapies, of vestibular symptoms in patients with both migraine and vertigo. The use of a standardized assessment tool to identify this unique population of patients will help future studies to test both the pathological model and effective treatment options.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. furman@pitt.edu
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Furman
authors.forename: Dawn A
authors.initials: DA
authors.lastname: Marcus
authors.forename: Carey D
authors.initials: CD
authors.lastname: Balaban
mesh_terms: D002540:Cerebral Cortex / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D008575:Meniere Disease / Q000175:diagnosis / Q000503:physiopathology; D008881:Migraine Disorders / Q000175:diagnosis* / Q000503:physiopathology; D009434:Neural Pathways / Q000503:physiopathology; D009460:Neurologic Examination; D013788:Thalamus / Q000503:physiopathology; D014278:Trigeminal Nuclei / Q000503:physiopathology; D020338:Vestibular Neuronitis / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D014726:Vestibular Nuclei / Q000503:physiopathology