Abstract:
Migraine-associated vertigo (MV) remains a developing entity because accepted diagnostic criteria are
unavailable. Patients present with debilitating dizziness without experiencing headache, and are often misdiagnosed as
anxious. The condition is manageable in primary care without the need for neurological referral. The aim of this study was
to investigate the prevalence of MV and migraine-associated dizziness (MD) as presenting complaints.
Methods: Patients presented with dizziness probably or definitely associated with migraine history based on the criteria of
the International Headache Society. Patients with other vestibulopathies and medical conditions were excluded. Patients
were evaluated over a period of nine months. Seven hundred and seventeen patients were examined. The numbers of
patients were recorded as a percentage of the population visiting a general practitioner. Response to migraine prophylactic
medications was regarded as supporting evidence of the diagnosis. Response was regarded as a complete resolution of
symptoms.
Results: Of the 717 patients seen, 12 were identified as having probable or definite MV. Five patients were treated with
migraine prophylactic medications, namely amitriptyline 25 mg nocte and/or sodium valproate CR 300 mg bd, and all
showed a response to the treatment.
Conclusions: We conclude that the prevalence of MV as presenting complaint may be as high as 1.67%. This figure does
however not reflect the total patient population that suffers from the condition – this figure may be much higher. Of those
patients treated for MV the response was 100%, further supporting the diagnosis. MV is a relevant complaint that is often
misdiagnosed as psychogenic in origin.
