Vestibular Migraine‐Like Syndrome in a Patient With Postttraumatic Headache and Medication‐Overuse Headache

TL;DR

A patient with post-traumatic and medication-overuse headaches developed vertigo resembling vestibular migraine, and migraine-focused treatment helped reduce symptoms.

Contribution

This case suggests that VM-like symptoms can occur in secondary headache disorders and may respond to migraine prophylaxis.

Findings

A patient with no migraine history exhibited VM-like symptoms following a head injury and medication overuse.

Treatment with amitriptyline and valproate reduced vertigo frequency and analgesic overuse.

This case highlights the potential overlap between secondary headaches and VM-like syndromes.

Abstract

Vestibular migraine (VM) requires a migraine history according to ICHD‐3, but recurrent vertigo may also develop in secondary headache disorders. We report a 52‐year‐old man who experienced persistent headache and recurrent vertigo following a traffic accident. His headache fulfilled criteria for chronic posttraumatic headache and later medication‐overuse headache. Vertigo attacks lasted minutes to 1 h and were accompanied by photophobia, phonophobia, and motion sensitivity, resembling VM despite no migraine history. Preventive therapy with amitriptyline and valproate reduced vertigo frequency and analgesic overuse. This case suggests that VM‐like syndromes can occur with secondary headaches, where migraine‐oriented prophylaxis may be useful.