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Current treatment options in vestibular migraine
Mark Obermann1, Michael Strupp2
1Department of Neurology, Vertigo and Dizziness Center, University of Duisburg-Essen , Essen , Germany.
Frontiers in Neurology
|December 25, 2014
Summary
Vestibular migraine affects 1% of people in industrialized nations and is often underdiagnosed. Current treatments lack robust evidence, with limited data on rizatriptan and zolmitriptan for acute attacks.
Area of Science:
- Neurology
- Ophthalmology
- Otolaryngology
Background:
- Vestibular migraine affects approximately 1% of the general population in industrialized countries.
- It is frequently underdiagnosed, despite recent diagnostic criteria.
- Treatment trials specifically for vestibular migraine are limited, with systematic randomized controlled trials only recently emerging.
Purpose of the Study:
- To review current treatment options for vestibular migraine.
- To provide an evidence-based treatment recommendation.
- To highlight the limitations of existing evidence.
Main Methods:
- Systematic review of available literature on vestibular migraine treatments.
- Analysis of randomized controlled trials (RCTs) and expert opinion.
- Consideration of ongoing clinical trials.
Main Results:
- Two RCTs provide limited evidence for rizatriptan and zolmitriptan in treating vestibular migraine attacks, but have methodological limitations.
- Prophylactic treatment recommendations are largely based on guidelines for migraine with and without aura, and expert consensus.
- An ongoing multicenter trial (PROVEMIG) is evaluating metoprolol for vestibular migraine prophylaxis.
Conclusions:
- Evidence for acute vestibular migraine treatment is currently limited.
- Prophylactic treatment strategies rely heavily on extrapolations from other migraine types and expert opinion.
- Further high-quality research, including ongoing trials, is crucial for establishing effective vestibular migraine management.
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