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Vestibular Migraine: Treatment and Prognosis
Michael von Brevern1, Thomas Lempert2
1Neurologisches Zentrum, Berlin, Germany.
Seminars in Neurology
|December 31, 2019
Summary
Vestibular migraine treatment lacks strong evidence, often using migraine therapies. Antiemetics can help acute attacks, while prophylaxis and non-drug methods manage frequent episodes.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Vestibular migraine treatment lacks high-quality randomized controlled trials.
- Current recommendations are often adapted from general migraine management strategies.
Purpose of the Study:
- To outline current therapeutic approaches for vestibular migraine.
- To highlight the evidence base, or lack thereof, for various treatments.
Main Methods:
- Review of existing literature and clinical guidelines for vestibular migraine.
- Comparison of pharmacological and non-pharmacological treatment options.
Main Results:
- Explanation and reassurance are the primary therapeutic steps.
- Antiemetics (e.g., diphenhydramine, meclizine) may alleviate acute attacks.
- Pharmacological prophylaxis options include metoprolol, amitriptyline, topiramate, valproic acid, and flunarizine.
- Non-pharmacological methods like exercise, relaxation, and biofeedback show comparable efficacy.
- Prognosis for vestibular migraine may be less favorable than for migraine headaches.
Conclusions:
- Vestibular migraine treatment relies on extrapolated migraine therapies due to limited specific research.
- A combination of pharmacological and non-pharmacological approaches is often recommended.
- Further research is needed to establish a firm scientific basis for vestibular migraine treatment.
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