Migraine management for the otolaryngologist

Brooks, Kaitlyn A.; Tawk, Karen; Djalilian, Hamid R.; Hobson, Candace E.

doi:10.1002/lio2.1109

Cited by 2 publications

(1 citation statement)

References 184 publications

(375 reference statements)

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“…Для профилактики мигрени используют бета-адреноблокаторы (пропранолол, метопролол, атенолол, надолол), блокаторы кальциевых каналов (флунаризин, циннаризин), моноклональные антитела к CGRP (эренумаб, фреманезумаб), антидепрессанты [33] и противоэпилептические препараты (топирамат, препараты вальпроевой кислоты). При психических нарушениях используются некоторые антипсихотические препараты (кветиапин, оланзапин) [34].…”

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Vestibular migraine: issues of diagnosis and optimization of therapy

Zaitseva,

Baskova,

Latsinova

et al. 2023

RJTAO

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Headache and dizziness are the two most common complaints with which patients turn to physicians of various specialties. A thorough examination often reveals a combination of these two symptoms. Currently, the term “vestibular migraine” (VM) is recognized by the worldwide community of otoneurologists and neurologists as the most appropriate for the combination of vestibular vertigo and migraine headaches. The difficulties in diagnosis and differential diagnosis are related to the lack of possibility to confirm the disease (and to detect) instrumentally and to the fact that the dizziness may be different in different VM episodes, even in one patient. The complexity of therapy is in the need to choose a relatively individualized treatment regimen and in the lack of an ideal vestibular suppressant (which quickly suppresses dizziness and has no significant side effects). In this context, finding the most effective drugs for emergency and elective treatment of patients with VM is undoubtedly important. For patients with VM, the use of the drug Arlevert (dimenhydrinate 40 mg + cinnarizine 20 mg) can be recommended for the relief of acute vestibular crisis at home, since the drug is highly effective and well tolerated. In addition, and most importantly, Arlevert has no known interactions with other medications used for migraine prevention.

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Vestibular migraine: issues of diagnosis and optimization of therapy

Zaitseva,

Baskova,

Latsinova

et al. 2023

RJTAO

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Monoclonal Antibodies Targeting CGRP to Treat Vestibular Migraine: A Rapid Systematic Review and Meta-Analysis

Frosolini,

Lovato

2024

Indian J Otolaryngol Head Neck Surg

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Vestibular migraine (VM), a subtype of migraine characterized by vestibular symptoms, poses a significant diagnostic and therapeutic challenge. This study aimed to evaluate the effectiveness of monoclonal antibodies targeting Calcitonin Gene Related Peptide (CGRP) in the treatment of VM. Therefore, we conducted a rapid systematic review and meta-analysis following PRISMA and Cochrane guidelines. A search of databases (PubMed, Scopus, Cochrane and Google Scholar) was performed in October 2023. Inclusion criteria required original research articles focusing on patients diagnosed with VM and utilizing CGRP-targeting monoclonal antibodies. We performed qualitative assessments of study design, patient characteristics, and outcomes and, for studies with comparable outcome measures, a meta-analysis was conducted. Our search yielded four relevant studies, including cohort studies and a case report, totaling 99 patients. Proper vestibular instrumental tests were employed in half of the studies. Overall, the included studies reported significant improvements in VM symptoms. Our quantitative analysis, focused on migraine symptoms, demonstrated a substantial reduction in Monthly Days with Migraine at 6 months following treatment. No severe adverse drug reactions were reported. In conclusion, this rapid systematic review and meta-analysis provide preliminary evidence for the efficacy of CGRP-targeting monoclonal antibodies in treating Vestibular Migraine. However, the absence of randomized controlled trials and variations in study designs and diagnostic criteria introduce some limitations. Further research is needed, including controlled trials, to establish a more robust evidence base. Nonetheless, this treatment approach offers hope for the effective management of VM, potentially enhancing the well-being of affected individuals and reducing their associated disability.

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Migraine management for the otolaryngologist

Cited by 2 publications

References 184 publications

Vestibular migraine: issues of diagnosis and optimization of therapy

Vestibular migraine: issues of diagnosis and optimization of therapy

Monoclonal Antibodies Targeting CGRP to Treat Vestibular Migraine: A Rapid Systematic Review and Meta-Analysis

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