Vestibuläre Migräne

 

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Zusammenfassung

Die Vestibuläre Migräne (VM) ist die häufigste Ursache spontan auftretender rezidivierender Schwindelattacken. Die Diagnose ist oft schwierig, was vor allem an der vielgestaltigen Symptomatik (“a chameleon among the episodic vertigo syndromes”) und den bislang uneinheitlichen Diagnosekriterien liegt. Ferner ist die Differenzierung von anderen Schwindelerkrankungen, wie z. B. Morbus Meniére oder Vestibularisparoxysmie, aber auch von nicht vestibulären Schwindelbeschwerden oft schwierig. Wichtig sind die familiäre Migränebelastung, die variable Dauer der Attacken (meist Minuten bis Stunden) mit Gangunsicherheit und Verstärkung von Augenbewegungsstörungen, die auch im attackenfreien Intervall bei 60% der Patienten nachweisbar sind, sowie der fehlende Kopfschmerz in etwa 30%. Die VM kann erfolgreich prophylaktisch therapiert werden.

Summary

Vestibular migraine (VM) is the most common cause of spontaneous episodic vestibular vertigo. Although VM is a well-recognized entity in specialized dizziness units, it is still underdiagnosed by general practitioners and neurologists. The main reasons for this are the inconsistent diagnostic criteria and the heterogeneous clinical presentation of VM (“a chameleon among the episodic vertigo syndromes”). Moreover, it is sometimes quite difficult to differentiate VM from other vertigo syndromes like Menière´s disease or vestibular paroxysmia, or from non-vestibular dizziness complaints. Important criteria include a family history of migraine, the varying duration of the attacks (lasting generally for minutes up to hours) with unsteadiness of gait and increased eye movement disorders (also observed in the attack-free interval in 60% of the patients), as well as the absence of headache in ca. 30%. Prophylactic treatment of VM is effective.

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