A 32-year-old woman with long-standing migraine without aura presents with repeated episodes of spontaneous rotational vertigo lasting several hours, accompanied by photophobia and headache during most attacks. Audiometry, caloric testing, and neurological examination between attacks are normal. The most likely diagnosis is:
- A Definite Meniere's disease
- B Vestibular paroxysmia
- C Vestibular migraine ✓
- D Bilateral sequential vestibular neuritis
Correct answer: C. Vestibular migraine
Explanation
Vestibular migraine is defined by at least five episodic vestibular attacks of moderate severity lasting 5 minutes to 72 hours, with current or past migraine and migraine features (headache, photophobia, phonophobia) in at least half the attacks, after excluding other causes. Normal audiometry between attacks distinguishes it from Meniere's disease, where hearing loss accompanies attacks and accumulates over time. Attack duration here also exceeds the seconds-long profile of vestibular paroxysmia.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.