Various factors have been identified as being migraine triggers, including foods, stress, hormones, physical activity, sensory stimuli, and environmental factors. Typically, migraine begins earlier in life than does MV, and it is not unusual for vertigo to replace headaches in women around menopause. MV may occur at any age and has a female preponderance with a probable autosomal dominant inheritance pattern with decreased penetrance in men. As a result, the trigeminal nerve releases chemicals that irritate and cause swelling of blood vessels on the surface of the brain, sending pain signals to the brainstem.
SYMPTOMS OF MIGRAINE AURA SERIES
Migraine is now believed to be a genetically based neurological disorder in which certain triggers start a series of events including functional changes in the trigeminal nerve system and imbalances in brain chemicals, such as serotonin, that regulate pain. Recently, diagnostic criteria have been proposed that separate definite MV from probable MV and that conceptualize MV as an episodic vestibular disorder. Furthermore, vertigo is not included in the International Headache Society classification system as a symptom of migraine except as a part of basilar migraine, so most patients who have migrainous vertigo (MV) cannot be classified using the existing criteria. Less than half of all migraine sufferers have received a diagnosis of migraine from their health care provider. The result is that even in patients with headaches, migraine is often misdiagnosed as sinus headache or tension-type headache. The delay is due, in part, to the fact that most patients and many physicians think of migraine only in terms of headache, when it is actually an organic neurological syndrome. Unfortunately, although migraine is a common cause of dizziness, it is often not correctly diagnosed until years after the patient initially seeks medical care for complaints of dizziness.
Specifically, vertigo, which is the sensation of perceived motion without actually moving, is reported by up to one third of people who have migraine, and general dizziness or unsteadiness is reported by up to three quarters of all patients with migraine. In reality, however, the cooccurrence of symptoms is much higher than that.
Thus, 3%–4% of the population can be expected to experience both dizziness and migraine.
Migraine is also a very common disorder, with prevalence in the general population ranging from 6%–20% in men and 17%–29% in women. Jaynee Handelsman, PhD, and Hussam El-Kashlan, MDĭizziness is one of the most common complaints in medicine and is reported to affect 20%–30% of the general population.
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