Neurologist (Brain Specialist)
Vestibular migraine has a very specific definition in the neurology field. Sufferers need to have at least 5 attacks of vertigo, a history or migraine, and episodes of vertigo between 5 minutes and 72 hours. Half of these episodes can occur without headache. Without all these features fulfilled, the diagnosis can be termed probable vestibular migraine.
Vestibular migraine is often suspected in patients after extensive vestibular investigations, there is no clear evidence of inner ear vestibular disease and brain imaging is normal. Outside of the other typical migraine features, a diagnosis of vestibular migraine is challenging, and sometimes further imaging and testing is required to exclude other brain diseases that may only be detected later with time.
Vestibular migraine may occur with headache after exhaustive investigation and is often responsive to similar treatment as chronic or episodic migraine with aura. Vestibular rehabilitation is also important.
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