Migraine vertigo
Ivanova T.A.¹, Guseva A.L.², Filatova E.G.<sup>1

1</sup> First Moscow State Medical University named after I.M. Sechenov
² Russian National Research Medical University named after N.I. Pirogov, Moscow

Migraine vertigo is common in the population and among the patients with other complaints, in particular the headache of tension. The prevalence of vertigo is about 20-30%, with dominance in women. The clinical and pathophysiological connection between migraine and vertigo is still unclear, approaches to the treatment of vestibular migraine (VM) have not been developed.
Aim: to determine the nature of vertigo in patients with migraine with aura and without aura, and pathogenetic mechanisms of their connection.
Patients and methods: 152 patients having migraine with aura (24 people) and without aura (128 people) were included into the study. All patients underwent a clinical neurological examination, and patients with a history of vertigo had an additional comprehensive otoneurological examination: videoistagmography, video pulse test, caloric assay, diagnostic positional maneuvers, and tone threshold audiometry. A questionnaire study of patients with migraine, who complained of dizziness, included: otoneurological questionnaire; and Dizziness Assessment Rating Scale.
Results: 58.6% of patients with migraine complained of vertigo, 2.6% had signs of peripheral vestibulopathy, 13.8% had vestibular migraine (VM), 42.1% suffered from non-rotary vertigo. VM was more often observed with chronic migraine (CM) and topiramate had a good therapeutic effect, both on the incidence of headache and on vertigo. There was also a positional character of vertigo with VM on DHI.
Conclusion: vertigo with VM has a mixed character, in the pathogenesis of which both central mechanisms in the form of central sensitization, and peripheral ones, caused by activation of the trigemino-vascular system are involved. In most patients, vertigo with VM is positional. The article shows that anticonvulsant topiramate is the drug of choice with proven effectiveness in migraine headaches. 

Key words: migraine, vestibular migraine, vertigo, topiramate
For citation: Ivanova T.A., Guseva A.L., Filatova E.G. Migraine vertigo // RMJ. 2017. № 9. P. 602–606.