Vertigo is frequently associated with
migraine, and sometimes it is the cardinal symptom. This type of
migraine is called "vestibular
migraine", "migrainous
vertigo", or "
migraine-associated
vertigo". Earlier findings on effective prophylactic medication for such
migraine attacks and their clinical features are few and insufficient. Our aim was to study the influence of prophylactic
therapy on this type of
migraine and to specify its clinical features. In a retrospective approach 100 patients (median age 47 years, range 21-72 years) with definite or probable vestibular
migraine were divided into two groups: those with (74 patients) and those without drug prophylaxis (26 patients). They were then interviewed by telephone at least 6 months after beginning
therapy. All patients receiving medical prophylaxis showed a decrease of duration, intensity, and frequency of episodic
vertigo as well as nearly all its associated features (p < 0.01). The group without medical prophylactic
therapy showed only a reduction of
vertigo intensity. Only 39 % of the 100 patients met the current IHS criteria for a
basilar-type migraine. Thus, we propose that a new category--"vestibular
migraine"--should be added to the HIS criteria. Furthermore, our data show that prophylactic medication may be effective for treating vestibular
migraine and its associated symptoms; therefore, patient's response to medical
therapy may provide guidance in the diagnostic process of vestibular
migraine.