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Current Treatment Options: Vestibular Migraine.

Clinton G Lauritsen1, Michael J Marmura2

  • 1Department of Neurology, Thomas Jefferson University, 900 Walnut St Suite 200, Philadelphia, PA, 19107, USA. Clinton.Lauritsen@jefferson.edu.

Current Treatment Options in Neurology
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PubMed
Summary

Vestibular migraine (VM) is a common cause of chronic vestibular issues, presenting with vertigo and imbalance. Effective treatments include acute medications like triptans and preventive strategies such as vestibular rehabilitation.

Keywords:
DizzinessMigraine-associated vertigoMigrainous vertigoVertiginous migraineVertigoVestibular migraine (VM)

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Area of Science:

  • Neurology
  • Otolaryngology

Background:

  • Vestibular migraine (VM) is a leading cause of chronic vestibular symptoms.
  • It presents with diverse clinical features, often fluctuating or daily, and can mimic other vestibular disorders.

Purpose of the Study:

  • To provide a clinical overview of Vestibular Migraine.
  • To discuss diagnostic considerations and treatment options for VM.

Main Methods:

  • Clinical diagnosis based on characteristic symptoms and exclusion of other conditions.
  • Review of current literature on VM pathogenesis and management.

Main Results:

  • VM symptoms include vertigo, disequilibrium, or imbalance, exacerbated by activity and head movements.
  • Hearing loss is absent in VM.
  • Migraine-specific medications (e.g., triptans) may treat acute attacks.

Conclusions:

  • VM diagnosis is primarily clinical, requiring differentiation from disorders like Meniere's disease.
  • Preventive treatments are crucial for frequent or disabling attacks, including vestibular rehabilitation and medications (propranolol, venlafaxine, topiramate, amitriptyline).
  • Refractory cases may benefit from acetazolamide or lamotrigine.