The interictal symptom burden in vestibular migraine—a condition in need of recognition - Summary - MDSpire

The interictal symptom burden in vestibular migraine—a condition in need of recognition

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Objective:

To summarize current evidence on persistent interictal manifestations of vestibular migraine (VM) and discuss their implications for diagnosis and clinical decision-making, particularly in differentiating between episodic and chronic forms.

Key Findings:
  • Vestibular migraine is characterized by episodic vestibular symptoms, but many patients experience persistent interictal symptoms that can complicate diagnosis.
  • Common interictal symptoms include head-motion intolerance, visually induced dizziness, positional vertigo, and increased susceptibility to motion sickness, which may affect daily functioning.
  • Altered central vestibular sensory and oculomotor networks are implicated rather than primary peripheral vestibular disorders, suggesting a need for targeted therapeutic approaches.
  • Interictal vestibular symptoms and ocular motor abnormalities may increase over time, even with decreasing attack frequency, indicating a potential chronicity of symptoms.
Interpretation:

The findings support a spectrum-based view of VM, where episodic attacks and persistent interictal symptoms represent different clinical expressions of the same disorder.

Limitations:
  • The review is narrative and not systematic, potentially limiting comprehensiveness and the ability to generalize findings.
  • Operational definitions may vary across studies, affecting comparability and interpretation of results, which should be acknowledged in clinical applications.
Conclusion:

A preliminary diagnostic framework for chronic vestibular migraine is proposed, detailing criteria for recognizing and managing interictal symptoms to improve clinical outcomes.

Original Source(s)

The interictal symptom burden in vestibular migraine—a condition in need of recognition

  • by H. M. Rust, A. Palla

  • May 5, 2026

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