Vestibular migraine: clinical aspects & pathophysiology 2013

Another new article for you to fetch, Scott (whenever you can of course…& thanks a bunch!) Just found out about it through a Google Scholar alert (love these!)…I’m sure you were alerted about it too, but, here it is just in case :slight_smile:

By Furman et al.

http://www.sciencedirect.com/science/article/pii/S1474442213701078

Good work Bren. Getting it now. 8)

A very up-to-date paper here that recognises the inclusion of vestibular migraine in the IHS criteria. 8)

*Lancet Neurology *2013. 12:706-15.

thanks for sharing Bren… great information!

Something always has me perplexed with vestibular migraine articles, and this one is no different - the list of diagnostic criteria always seems to list a duration of UP TO 72 hours… so how do you explain all the people being sick with this every single day for years? Do we represent a subset of migraineurs with permanent vestibular damage aggravated by vestibular migraine? Would they classify us as having chronic migraine so that each attack runs into the next with no break? Something else? I understand that there has to be a list of criteria for a number of reasons, but still I feel like we are always left out. Does anyone have any info as to what the top guys in the field have to say about this?

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so how do you explain all the people being sick with this every single day for years? Do we represent a subset of migraineurs with permanent vestibular damage aggravated by vestibular migraine?

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I hear you DFL and I have the same questions. I don’t think there is any basis to say there is “vestibular damage” because that would presumably be captured on testing. Your query is even more compelling for the large number of people on this site that have their imbalance, vertigo, dizziness WITHOUT headache since that makes it even harder to fit within the diagnostic criteria. My guess is that there will someday be a classification of “chronic vestibular migraine” that would cover it as opposed to right now having “chronic migraine” and “vestibular migraine”. Alternatively, one can infer this diagnosis because of the existence of both subsets.

Good article. A little on the technical side in places. :?

Andy

See the Diagnostic Criteria for this (page 171):

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3.11. Chronic vestibular migraine

In this classification, vestibular migraine is conceptualized as an episodic disorder. However, a chronic variant of vestibular migraine has been reported. A distinction between chronic vestibular migraine and comorbid psychiatric dizziness syndromes seems particularly challenging in these patients. In the future, following additional research, chronic vestibular migraine may become a formally recognized category of a revised classification.

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See the Diagnostic Criteria for this (page 171):

— Begin quote from ____

3.11. Chronic vestibular migraine

— End quote

In this classification, vestibular migraine is conceptualized as an episodic disorder. However, a chronic variant of vestibular migraine has been reported. A distinction between chronic vestibular migraine and comorbid psychiatric dizziness syndromes seems particularly challenging in these patients. In the future, following additional research, chronic vestibular migraine may become a formally recognized category of a revised classification.

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Ah cool, thank you. I wonder how long it will take to find its way into the official classification system, if it does at all. I know we know it exists, but it seems as far as insurance and attitudes in the more general medical field go, it would give it a little more credit and make it easier for many of us to be able to get treatment covered.

Scott,

Thanks for posting. I swear I hadn’t read that – I thought I would get credit.

:smiley:

Andy