In the differential are TIAs and paroxysmal vestibular disorders accompanied by headache. Patients usually respond diet or the usual prophylactic drugs. Auditory symptoms are rare compared to vestibular symptoms but nevertheless there is good evidence that hearing loss and tinnitus do occur. Benign Paroxysmal Vertigo of Childhood , is a disorder of uncertain origin, possibly migrainous. The differential diagnosis includes Menieres disease , vestibular epilepsy, perilymphatic fistula , posterior fossa tumors, and psychogenic disorders.
Vestibular testing can document profound bilateral vestibular loss.
Also reported by Baloh and associates, a form exists with episodic vertigo and essential tremor. This form is also responsive to acetazolamide. French-Canadian intermittent ataxia syndrome also may present similarly. While no mutations have been identified in the common form of migraine, calcium channels could be functionally impaired by subtle gene changes such as polymorphisms. While controversial, there are some reports that individuals with severe migraine headaches are more likely to have antiphospholipid antibodies.