Vestibular Migraine With Brainstem Auras: A Review of Pathogenesis, Clinical Varieties, Abortive and Prophylactic Treatment

Abstract

Vestibular migraine (VM) is the most common etiology of vertigo in the adults. VM accompanied by brainstem symptoms is not uncommon, but underrecognized so far. It is often misdiagnosed as brainstem infarction. Earlier correct diagnosis could help avoid thrombolysis, intravascular intervention, excessive auxiliary examination, panic and fear, repeated hospitalization, waste of medical resources, early and short-term use of steroid hormone, and antioxidant. Family or sporadic hemiplegic migraine (HM) is a kind of encephalopathy instead of simple hypoperfusion; the pathogenesis, which was not well described, might also account for the neurological symptoms in VM patients. The genomic identification of the migraine could facilitate better understanding on molecular pathogenesis of familial HM. Genetic mutations are believed to be associated with more susceptible alterations of cortical spreading depression in the brain.