BPPV Associated with Migraine

[size=150]Benign Paroxysmal Positional Vertigo Associated with Migraine[/size]

Nana Tevzadze
Headache Care 2005;2:119–125.

*Evidence continues to emerge substantiating an epidemiologic association between migraine and vertigo. Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the peripheral vestibular system affecting up to 21% of vertigo patients. We evaluated 14 patients (10 females and four males aged 40–50 years) with migraine headache and a history typical of BPPV in our outpatient clinic. All patients had suffered from migraine for between 10 to 20 years. Ten patients had typical features for BPPV and seven of them improved following liberatory repositioning manoeuvres. Symptoms in three patients resolved spontaneously. The remaining four of our patients (three female, one male) had positional vertigo with features atypical for BPPV during the symptomatic period. It was probable that our patients have short-lasting paroxysmal migrainous vertigo, mimicking BPPV and that their symptoms were probably the result of abnormalities of central processing in the brainstem or vestibulocerebellar pathways. This review explores the epidemiological and shared pathogenetic mechanisms linking migraine and BPPV. Several studies have demonstrated effective treatment of patients experiencing vertigo associated with migraine. An increased understanding of the common pathophysiology of migraine and the vestibular system is likely to improve pharmacological treatment strategies for vestibular symptoms in patients with both migraine and vertigo. *