The Treatment of Vestibular Migraine: A Narrative Review

Shen, Youjin; Qi, Xiaokun; Wan, Tingyu

doi:10.4103/aian.aian_591_19

Cited by 16 publications

(3 citation statements)

References 49 publications

(27 reference statements)

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“…It accounts for about 11% of patients seen in dizziness clinics and 13% of patients seen in migraine clinics [5,6]. Similar to migraine, for VM, a female preponderance is observed [7].…”

Section: Introductionmentioning

confidence: 99%

Vestibular Migraine Therapy: Update and Recent Literature Review

Zanandrea,

Colombo,

Filippi

2023

Audiology Research

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Vestibular migraine (VM) is a neurological condition that causes vertigo and headache. It is considered the most common cause of episodic vertigo. However, specific treatments are missing, and medications currently used in VM are borrowed from migraine therapy. A comprehensive practical review of the literature assessing the evidence for abortive and preventive interventions in adults with VM was published in 2022, providing practical recommendations about VM treatment. The aim of our paper is to provide an updated overview of the current state of the art of VM treatment, illustrating new evidence available in this field. Along with traditional pharmacological preventive therapies, medications targeting the CGRP pathways have recently been investigated in terms of treatment effect in VM patients, with encouraging results. Also, there is new evidence of the efficacy of non-pharmacological interventions. However, the overall evidence base for VM treatment remains sparse.

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“…It accounts for about 11% of patients seen in dizziness clinics and 13% of patients seen in migraine clinics [5,6]. Similar to migraine, for VM, a female preponderance is observed [7].…”

Section: Introductionmentioning

confidence: 99%

Vestibular Migraine Therapy: Update and Recent Literature Review

Zanandrea,

Colombo,

Filippi

2023

Audiology Research

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“…[3] Although its pathophysiological mechanism is not fully understood, it is believed that there is a combination of dysregulation of central mechanisms and peripheral labyrinthine alterations involved in the genesis of symptoms. [4,5] Treatment for vestibular migraine encompasses the prevention of crises and the treatment of acute symptoms. Several classes of medications can be used as preventatives, including beta blockers, anticonvulsants, antidepressants and calcium channel antagonists.…”

Section: Introductionmentioning

confidence: 99%

Use of Flunarizine as a Preventive for Vestibular Migraine Crises in Comparison With Other Drugs: Systematic Literature Review

Braghieri¹,

Person

Bogar

et al. 2021

Preprint

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INTRODUCTIONVestibular migraine is the main cause of episodic vertigo and the second most common cause of dizziness in adults. Treatment for vestibular migraine encompasses the prevention of crises and the control of acute symptoms.Flunarizine works by preventing the contraction of labyrinthine vessels and altering blood flow, thus preventing symptoms. Due to the high prevalence of the disease, its negative impacts on individual health and increased expenditure on public health, preventive pharmacological and non-pharmacological treatment must be implemented early.PURPOSETo evaluate the efficacy of Flunarizine as a preventive for migraine and vestibular crises compared to other preventive drugs.MATERIAL AND METHODSScientific articles were searched in the databases using the terms (vestibular migraine OR migrainous vertigo) AND (flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, including 3 randomized clinical trials comparing flunarizine and other preventive drugs in terms of efficacy and safety for preventing migraine vertigo attacks. The studies were analyzed using a ROB table, analysis using the GRADE method and meta-analysis.RESULTSQualitatively, the analysis showed that flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with a moderate degree of evidence, a relative risk of 0.34 and a confidence interval of 0.15 to 0.76.CONCLUSIONSThere are few studies available in the scientific literature on the use of flunarizine in vestibular migraine, many of which are heterogeneous among themselves, mainly in the way of evaluating and monitoring patients, carried out mainly through subjective methods.The meta-analysis showed a positive result for flunarizine as a preventive drug for the studied population. Furthermore, in all the studies analyzed, no serious side effects resulting from the use of the medication were reported, which makes it safe for patients to use.Flunarizine is a good drug for the prevention of vestibular migraine, especially in reducing the number of attacks, with a good level of evidence.

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“…This link between MVDS and migraines needs to be explored in future studies [8]. Amitriptyline, a tricyclic antidepressant, is commonly used for prophylaxis of vestibular migraine [27].…”

mentioning

confidence: 99%

Motorist’s Vestibular Disorientation Syndrome (MVDS)—Proposed Diagnostic Criteria

Pawar¹,

Ashraf²,

Dorsala

et al. 2023

JPM

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Motorist’s vestibular disorientation syndrome (MVDS) is a disorder in which patients experience dizziness while driving. MVDS is under-reported in the literature, and in clinical practice, it often goes unrecognized. We identified clinical characteristics of patients with MVDS using data from 24 patients who faced difficulties while driving and were diagnosed with MVDS. Their symptoms, duration of illness, precipitating factors, co-morbidities, history of other neuro-otological disorders, severity of symptoms, and associated anxiety and depression were reviewed. Ocular motor movements were recorded using video-nystagmography. Patients with vestibular disorders that can cause similar symptoms while driving were excluded. The mean age of the patients was 45.7 ± 8.7 years, and most were professional drivers (90.5%). The duration of the illness ranged from eight days to ten years. Most patients presented with disorientation (79.2%) exclusively while driving. The most common triggers for symptoms were higher speeds, i.e., >80 km/h (66.7%), multi-lane roads (58.3%), bends and turns (50%), and looking at other vehicles or signals while driving (41.7%). A history of migraines was reported in 62.5% of the patients, and motion sickness was reported in 50% of the patients. Anxiety was reported in 34.3% of patients, and 15.7% had depression. The video-nystagmography did not show any specific abnormalities. Patients responded to drugs used in prophylactic treatments for migraines such as Amitriptyline, Venlafaxine, Bisoprolol, and Magnesium, and to Pregabalin and Gabapentin. Based on these findings, a classification system and a diagnostic criterion for MVDS were proposed.

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The Treatment of Vestibular Migraine: A Narrative Review

Cited by 16 publications

References 49 publications

Vestibular Migraine Therapy: Update and Recent Literature Review

Vestibular Migraine Therapy: Update and Recent Literature Review

Use of Flunarizine as a Preventive for Vestibular Migraine Crises in Comparison With Other Drugs: Systematic Literature Review

Motorist’s Vestibular Disorientation Syndrome (MVDS)—Proposed Diagnostic Criteria

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