A patient presents with recurrent spontaneous episodes of vertigo lasting 5 minutes to several hours, with photophobia and phonophobia between episodes, and a history of migraine. Caloric and VEMP testing are normal. The most likely diagnosis is:
- A Meniere's disease
- B Transient ischemic attack of vertebrobasilar territory
- C Vestibular migraine ✓
- D Recurrent vestibulopathy
Correct answer: C. Vestibular migraine
Explanation
Vestibular migraine is characterized by episodic vertigo associated with migraine features (photophobia, phonophobia, personal or family history of migraine). Normal caloric and VEMP results support a central diagnosis rather than peripheral end-organ disease. Meniere's would show hearing loss and possible EcochG changes. TIA would have brainstem signs. Recurrent vestibulopathy lacks migraine features.
Reference: Barany Society Diagnostic Criteria, 2015 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.