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Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity
Isabel Luzeiro1, Leonel Luís2, Freire Gonçalves3
1Neurology Department, Coimbra Hospital and University Centre, Coimbra, Portugal; Centre for Sleep Medicine, Coimbra Hospital and University Centre, Coimbra, Portugal; Laboratory for the Study of Language, Faculty of Medicine, University of Lisboa, Lisboa, Portugal.
Abstract:
Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice. We conclude that clinical studies using a multidisciplinary approach are crucial in this field, since different specialists observe the same pathology with different eyes. Clinical presentation of VM is variable in what concerns vestibular symptoms temporal relation with migraine headache, as well as in their accompanying manifestations. Biomarkers, either genomics or functional, and molecular imaging techniques will be helpful to clarify many aspects of the complexity of this entity, helping to define to what extent can VM be considered a separate and independent clinical entity.
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