Case · Foundation · Vestibular migraine
Recurrent vertigo with photophobia
28-year-old woman, longstanding migraine without aura.
Vignette
A 28-year-old woman with a history of episodic migraine without aura presents with her fifth episode of spinning vertigo. Each episode lasts 4–12 hours, accompanies a unilateral throbbing headache with photophobia, and resolves completely. Between episodes she is asymptomatic.
Diagnostic question
Is HINTS appropriate here, and what is the most likely diagnosis?
Teaching point
HINTS is for acute, continuous vestibular syndromes. It does not adjudicate episodic vertigo. Recurrent vertigo with migrainous features and full recovery between attacks should be assessed against the Bárány Society / IHS vestibular migraine criteria, not HINTS.