Publication:

Decoding vestibular migraine for easier diagnosis

Background Due to the absence of a unified set of diagnostic criteria, vestibular migraine is always an underdiagnosed entity. This study was undertaken to find specific pointers in the diagnostic protocol which can help in diagnosing vestibular migraine and also to assess our treatment module for vestibular migraine.

Methods An elaborate proforma was prepared for evaluating each patient at our vertigo clinic for a time period of two years. A detailed history is followed by general examination, ENT examination, specific tests for eyes, tests for vestibulospinal tract, and also a few more tests such as Doppler, pure tone audiogram, ECHO etc. when the diagnosis was in doubt. A total of 206 patients were evaluated. Vestibular migraine cases were started on our drug regimen of Tab flunarizine once daily and subjected two follow ups (at 4 weeks and 12 weeks).

Results Total of 20 patients (9.7%) diagnosed as vestibular migraine. There was a slight preponderance to female population. A positive history of recurrent headache and neck pain were definitive clinchers in diagnosing vestibular migraine. All 20 patients had alleviation of symptoms with regards to severity and frequency of episodes.

Conclusions Detailed history and elaborate vestibular examination alone is necessary for diagnosing vestibular migraine. Flunarizine regimen for a period of 3 months is found to be effective in relieving the symptoms. Adjuvant vestibular rehabilitation exercises mandatory for total alleviation of symptoms.