Vestibular Migraine: from Differential Diagnosis and Pathophysiology to Treatment Options

Background: The occurrence of migraine and vertigo is common in the general population. Migraine vertigo is challenging and has several common symptoms with inner ear pathologies like Endolymphatic Hydropse. This paper presents a review of recent findings about symptoms, test results, pathophysiology and differential diagnosis. Methods: The present study is a review of 35 papers in the field of vestibular migraine. They were selected by searching the keywords vertigo, dizziness, migraine, treatment and rehabilitation in Pubmed, ScienceDirect, Scopus and Google Scholar search engines. Only human studies were included. Results: Recent findings have proposed several common pathophysiologies between vestibular system and migraine including spreading depression in the basilar artery, vasospasm in the internal auditory artery, involvement of the connection with locus coeruleus, dorsal raphe nucleus, disorder of multisensory integration and channelopathy. Conclusion: For the differential diagnosis of vestibular migraine, it appears that comprehensive case history as well as clinical testing and patient followup, are the best combination. In addition, it has been proven that vestibular rehabilitation is beneficial to patients with vestibular migraine.