Case 09 · trainee
Episodic vertigo, headache, and a wandering SVV
Vignette
A 28-year-old woman with a history of migraine without aura presents with three discrete episodes of vertigo over the last year, each lasting 2–4 hours, accompanied by photophobia and a unilateral pulsating headache. Bucket SVV across the three attacks: episode 1 was +3.5°, episode 2 was −2.0°, episode 3 was +0.5°. Between attacks SVV normalises completely. Audiogram and caloric testing are normal. MRI is normal.
SVV trace
Variable SVV tilt that changes direction across attacks