Tarnutzer, A.A.; Kaski, D. What’s in a Name? Chronic Vestibular Migraine or Persistent Postural Perceptual Dizziness? Brain Sci.2023, 13, 1692.
Tarnutzer, A.A.; Kaski, D. What’s in a Name? Chronic Vestibular Migraine or Persistent Postural Perceptual Dizziness? Brain Sci. 2023, 13, 1692.
Tarnutzer, A.A.; Kaski, D. What’s in a Name? Chronic Vestibular Migraine or Persistent Postural Perceptual Dizziness? Brain Sci.2023, 13, 1692.
Tarnutzer, A.A.; Kaski, D. What’s in a Name? Chronic Vestibular Migraine or Persistent Postural Perceptual Dizziness? Brain Sci. 2023, 13, 1692.
Abstract
Current consensus diagnostic criteria for vestibular migraine (VM) describes this as an episodic disorder. However, a minority of patients report prolonged (>72h duration) or even persistent VM symptoms, prompting whether a chronic variant of vestibular migraine (CVM) should be introduced to the current classification and how best to define it. Here we summarize current evidence of such a potential chronic variant of VM and critically review previously published proposed definitions for CVM. Potential approaches to establish a diagnostic framework for CVM include a) following the distinction between episodic and chronic migraine headaches; namely, frequent and/or prolonged episodes of VM (but not persistent vertigo or dizziness) in the context of chronic migraine headaches or b) daily dizzy spells over more than 6 months that responded well to prophylactic anti-migraine therapy. A key challenge when defining diagnostic criteria for CVM is how to distinguish it from other chronic vestibular syndromes such as motion sickness, persistent postural-perceptual dizziness (PPPD), and mal-de-débarquement syndrome. Indeed, more than 50% of patients with PPPD and up to 46% with mal-de-débarquement syndrome fulfill diagnostic criteria for episodic migraine headaches, suggesting these disorders may all lie along a spectrum. We propose that when VM becomes persistent, it is best classified as PPPD but that VM and PPPD are not mutually exclusive, such that patients with PPPD need not have features of VM and the triggering event for persistent dizziness may be independent of migraine.
Keywords
chronic vestibular syndrome; dizziness; headache; vertigo; somatoform; migraine; mal de débarquement
Subject
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
