Vestibular migraine treatment: a comprehensive practical review

Area of Science:

• Neurology
• Otolaryngology

Background:

• Vestibular migraine is an underdiagnosed neurological condition causing episodic vertigo and migraine features.
• It is the most common cause of spontaneous episodic vertigo, affecting up to 1% of the population.
• Existing meta-analyses show low-quality evidence for preventative treatments, hindering preferred strategy establishment.

Purpose of the Study:

• To provide pragmatic management guidelines for vestibular migraine in adults.
• To conduct a systematic qualitative assessment of evidence for abortive and preventative interventions.
• To address the clinical need for specific vestibular migraine treatment strategies.

Main Methods:

• Systematic qualitative assessment of available evidence for interventions.
• Review of abortive and preventative treatment options for adults.
• Synthesis of evidence to formulate practical recommendations.

Main Results:

• The overall evidence base for vestibular migraine treatment is of low quality.
• Practical treatment recommendations are provided based on the available evidence and clinical experience.
• Areas for improvement in future clinical trial design are discussed.

Conclusions:

• There is a significant clinical need for evidence-based management guidelines for vestibular migraine.
• Clinicians can utilize the provided recommendations for practical patient management.
• Future research should focus on improving the quality of evidence through well-designed clinical trials.