EVALUATION OF TREATMENT OUTCOMES OF VESTIBULAR MIGRAINE PATIENTS
DOI:
https://doi.org/10.21776/ub.mnj.2022.008.02.4Keywords:
Vestibular migraine, dizziness, pharmacologic treatmentAbstract
Background: Currently there are several treatment plans for prophylaxis of vestibular migraine, but these treatments are based on physician's observations and there have not been studied on a consensual treatment plan.
Objective: Based on diagnostic criteria, we collected vestibular migraine patients and created an individualized treatment plan for 3 months to interpret treatment results.
Methods: In this prospective cross-sectional study, 28 patients with headache and dizziness diagnosed for vestibular migraine were enrolled. Demographics, clinical picture, and treatment results were evaluated for all patients at baseline and after three months follow-up duration. Collected data analyzed by statistical methods in SPSS.
Results: Due to results, all of the patients with vestibular migraine were female and mostly were in the 30 to 50 years old age group. Dizziness, Headache before vestibular symptoms, increased intensity of headache on excretion, intermediate to high migraine intensity, and throbbing pain were the most common symptoms in the patients. The most common drugs used in the treatment were somatriptan, topiramate and Magnesium+Vitamin B6. After 3 months of treatment, duration, intensity, and frequency of migraine and frequency of dizziness episodes were significantly decreased but there was not a significant relationship between treatment plan and dizziness episodes in terms of duration and intensity.
Conclusion: Effectiveness of the drugs in decreasing dizziness episodes can be explained by the effect of the drugs in preventing migraine episodes, whereas in recent studies non-pharmocologic treatments have had a significant effect on decreasing dizziness intensity and duration. Using both pharmacologic and non-pharmocologic methods in combination, is recommended for the treatment of the vestibular migraine.
References
Neuhauser H, Leopold M, Von Brevern M, Arnold G, Lempert T. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology; 2001. 56(4):436–41. DOI: 10.1212/wnl.56.4.436
Rothrock JF. Understanding migraine: a tale of hope and frustration. Headache J Head Face Pain; 2011. 51(7):1188–90.
Lai J, Dilli E. Migraine aura: Updates in pathophysiology and management. Curr Neurol Neurosci Rep; 2020. May;20(6):17.
DOI: 10.1007/s11910-020-01037-3
Basser LS. Benign paroxysmal vertigo of childhood: A variety of vestibular neuronitis. Brain; 1964. 87(1):141–52.
von Brevern M, Lempert T. Vestibular migraine. Handb Clin Neurol; 2016. 137:301–16.
DOI: 10.1016/B978-0-444-63437-5.00022-4
Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res; 2012. 22(4):167–72. DOI: 10.3233/VES-2012-0453
Balaban CD. Migraine, vertigo and migrainous vertigo: Links between vestibular and pain mechanisms. J Vestib Res; 2011. 21(6):315–21.
DOI: 10.3233/VES-2011-0428
Aragones JM, Fortes‐Rego J, Fuste J, Cardozo A. Migraine: An alternative in the diagnosis of unclassified vertigo. Headache J Head Face Pain; 1993. 33(3):125–8. DOI: 10.1111/j.1526-4610.1993.hed3303125.x
Savundra PA, Carroll JD, Davies RA, Luxon LM. Migraine-associated vertigo. Cephalalgia; 1997. 17(4):505–10. DOI: 0.1046/j.1468-2982.1997.1704505.x
Kroenke K. The interface between physical and psychological symptoms. Prim Care Companion J Clin Psychiatry; 2003. 5(suppl 7):11–8. Available from: https://www.psychiatrist.com/read-pdf/25220/
Stewart WF, Simon D, Shechter A, Lipton RB. Population variation in migraine prevalence: a meta-analysis. J Clin Epidemiol; 1995. 48(2):269–80.
Available from:
Osborne JR. The differential diagnosis of ménière’s disease and vestibular migraine; 2017.
DOI: 10.26021/7591
Buchanan TM, Ramadan NM. Prophylactic pharmacotherapy for migraine headaches. In: Seminars in neurology. Copyright© 2006 by Thieme Medical Publishers, Inc. 333 Seventh Avenue, New; 2006. p. 188–98. DOI: 10.1055/s-2006-939919
Bogdanov VB, Multon S, Chauvel V, Bogdanova OV, Prodanov D, Makarchuk MY, et al. Migraine preventive drugs differentially affect cortical spreading depression in rat. Neurobiol Dis; 2011. 41(2):430–5. DOI: 10.1016/j.nbd.2010.10.014
Lampl C, Katsarava Z, Diener HC, Limmroth V. Lamotrigine reduces migraine aura and migraine attacks in patients with migraine with aura. J Neurol Neurosurg Psychiatry; 2005. 76(12):1730–2.
DOI: 10.1136/jnnp.2005.063750
Chen W, Fuh J, Lu S, Wang S. Persistent migrainous visual phenomena might be responsive to lamotrigine. Headache J Head Face Pain; 2001. 41(8):823–5.
DOI: 10.1046/j.1526-4610.2001.01150.x
Lempert T, von Brevern M. Vestibular migraine. Neurol Clin; 2019. Nov;37(4):695–706.
DOI: 10.1016/j.ncl.2019.06.003
Lempert T. Vestibular migraine. In: Seminars in neurology. Thieme Medical Publishers; 2013. p. 212–8. DOI: 10.1055/s-0033-1354596
Bisdorff AR. Management of vestibular migraine. Ther Adv Neurol Disord; 2011. 4(3):183–91.
DOI: 10.1177/1756285611401647
Celiker A, Bir LS, Ardiç N. Effects of valproate on vestibular symptoms and electronystagmographic findings in migraine patients. Clin Neuropharmacol; 2007. 30(4):213–7.
DOI: 10.1097/wnf.0b013e31803bb3ee
Carmona S, Settecase N. Use of topiramate (topamax) in a subgroup of migraine‐vertigo patients with auditory symptoms. Ann N Y Acad Sci; 2005. 1039(1):517–20. DOI: 10.1196/annals.1325.057
Johnson GD. Medical management of migraine‐related dizziness and vertigo. Laryngoscope; 1998. 108(S85):1–28. DOI: 10.1097/00005537-199801001-00001
Gode S, Celebisoy N, Kirazli T, Akyuz A, Bilgen C, Karapolat H, et al. Clinical assessment of topiramate therapy in patients with migrainous vertigo. Headache J Head Face Pain; 2010. 50(1):77–84.
DOI: 10.1111/j.1526-4610.2009.01496.x
Baier B, Winkenwerder E, Dieterich M. Vestibular migraine: Effects of prophylactic therapy with various drugs. A retrospective study. J Neurol; 2009 Mar;256(3):436–42. DOI: 10.1007/s00415-009-0111-3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Malang Neurology Journal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
