Recognizing vestibular migraine in primary care 2014

I am very proud to say that I just published an article on VM. This took me over 2 years to complete, but it was approved and is currently is in the June edition of Clinician Reviews. I will attach the link below, but I am not sure if you will be able to access the article without entering your email address. I am a chronic VM sufferer, and although there is current criteria, I know that not all of us meet this based on our long-standing symptoms. Dr. Timothy Hain has also updated his website to include the new IHS VM criteria, but I don’t think he finds it to be exactly correct either. Needless to say this is a step in the right direction for us in getting the right diagnosis and appropriate treatment. The journal has posted articles on dizziness and vertigo for the last 2 months, so this fits right in. Check it out!

Original website link is here: … cb519.html

Hi All,

We should be very proud of Jen. What an amazing accomplishment. I have been chatting with Jen off and on while this paper was being written. She has been totally committed to making this happen and BOOM, it’s done. She has also provided me with some excellent insights into migraine over the years. She is a MAJOR asset to this community.

Big congratulations Jen. I know how difficult it is to have a paper peer reviewed, accepted and published. :smiley:

How great coming from a person who lives with this as well as having the skill and knowledge to write something of this caliber.


I will definitely read as soon as I can-- congratulations and thank you for bring this to light.

Congratulations Jen, what a fantastic publication. As a published scientist I can understand what a task it was to write and get it accepted for publication. It must be unusual for one of he authors to actually have the illness. The only criticism would be that it doesn’t make it clear that symptoms can be chronic. It may give the impression that it is just episodic and I think this is a misunderstanding that has lead to so many of us being misdiagnosed. Also why was pizotifen left out of the list of medications because it is one of the only drugs that is actually licenced for migraine.
I hope that people can see your posting. It is a bit difficult to see because it has been moved to the top of the page.
Really glad u r doing well on your meds x

becks we dont have pizotifen here in the states it blows it could actually help us over here

Ah I didn’t realise it was an American publication. It so strange u can’t get it. Sometimes over here it is described as being a completely useless drug for migraine and other times it is seen as a first line therapy. Noritriptyline isn’t widely available in the UK for some reason.

oh yea here at least for me the drs. seem to like to start with nortriptyline…sucks we can’t all get the same opportunities ugh. also with some insurances here like they will cover gabapentin first before lyrica because it is cheaper…or some might not even cover lyrica at all.


The evidence is lacking about the chronic nature of this – I have not seen it much at all in the science literature and it is only just touched upon in the IHS Diagnostic Criteria (2012).

— Begin quote from ____

a chronic variant of vestibular migraine has been reported (two references) … In the future, following additional research, chronic vestibular migraine may become a formally recognized category of a revised classification.

— End quote

Jen’s original article had to be cut down significantly and perhaps there was more about chronicity there. Note that the article does say “chronic disequilibrium” under Clinical Manifestations of VM.

As noted above, pizotifen is not available in the US.

— Begin quote from ____

I hope that people can see your posting. It is a bit difficult to see because it has been moved to the top of the page

— End quote

If posts like this are not converted into “stickies” they gradually disappear from the front page. Members of any forum or group should always look at stickies and announcements for more important information.


Thanks for chiming in there Scott!

My original paper was very LONG, and had to be scaled down A LOT. Also, when it goes through peer review they require evidence. Unfortunately most of the other articles out there on VM don’t explain our symptoms accurately. I got as much as I could in there, and was able to include chronic disequilibrium and visual vertigo. Actually, the new IHS diagnostic criteria came out as I was writing this paper. As far as the medications go…our medical community goes by evidence-based practice, so I had to list the medications by their levels of efficacy. If you run through the list, I am sure many of us have trialed most of the medications at one point or another, and some of the drugs shown not to be helpful work well for some of us. For example gabapentin and verapamil appear in the category “U” and are labled “inadequate or show conflicting data.” I believe Dr. hain uses verapamil, and I know many of you have had success with gabapentin.

I think it is imortant to realize how far we have come. We also know much more about VM than we did just a few years ago. We now have a diagnosis, and some EBP treatment guidelines. Those of us suffering can go armed to our providers with a multitude of “evidence” showing that we can be diagnosed with a good deal of certainty and treated adequately and appropriately. I am confident that this article will shed more light on dizziness, and that there are providers that now know a diagnosis of VM exists…

Thanks for all if your support. This was a lot of work, and I don’t think I will be writing another article anytime in the near future :slight_smile:

Thank you for publishing such a great paper. Appreciate your hard work! We are fortunate to have this info available on our forum. I’ll give my General Practitioner a copy of your paper when I go for my next appt. She is always interested in new info on VM but hasn’t had much experience in treating it.

I’ve just returned from a trip to Sydney to see my Neurologist - it’s worth the journey to get an experienced VM specialist’s opinion. Hopefully more neurologists will take an interest in diagnosing and treating Vestibular Migraine with more information being made available.

Thank you Jen for all your hard work, and congratulations on getting it published!

I find it rather timely, as I feel a relapse approaching and I’m sure my doctor will be interested in reading it.