title: The challenge of vestibular migraine.
abstract: OBJECTIVE
  Migraine is a common illness and migraine-related dizziness occurs in up to 3% of the population. Because the diagnosis is controversial and may be difficult, many patients go undiagnosed and untreated. This review summarizes current understanding of the taxonomy and diagnosis of vestibular migraine, the relation of vestibular migraine to labyrinthine disease, and the treatment of the condition in adults and children.
  
  
  RESULTS
  The categories of migraine accepted by the International Headache Society do not reflect the complex presentations of patients suspected of having vestibular migraine. In clinical practice and research, criteria are increasingly accepted that divide patients suspected of vestibular migraine into 'definite vestibular migraine' and 'probable vestibular migraine.' Because vertigo itself may trigger migraine, patients with vestibular migraine should be suspected of having vestibular end-organ disease until proven otherwise. Treatment remains controversial because of a notable lack of randomized controlled studies of vestibular migraine treatment.
  
  
  CONCLUSIONS
  For now, the best strategy for the treatment of suspected vestibular migraine patients is dietary/lifestyle modification, antinausea/antiemetics for acute vertigo, and preventive medication for patients who have continued disruptive symptoms. Patients with vestibular migraine should be monitored regularly for the development of latent audiovestibular end-organ disease.
authors.affiliation: Michigan Ear Institute, Farmington Hills, Michigan 48334, USA. esargent@michiganear.com
authors.forename: Eric W
authors.initials: EW
authors.lastname: Sargent
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D065635:Benign Paroxysmal Positional Vertigo; D003937:Diagnosis, Differential; D004032:Diet; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008019:Life Style; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology; D008881:Migraine Disorders / Q000175:diagnosis* / Q000503:physiopathology; D000077236:Topiramate; D014717:Vertigo / Q000175:diagnosis
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose