Vestibular Migraine

Beh, Shin C.

doi:10.1007/s11910-022-01222-6

Cited by 15 publications

(8 citation statements)

References 87 publications

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“…Patients had no significant reduction in DHI, and instrumental vestibular examination remained altered (from 33.5 ± 6.9 to 31.8). As previously reported, conventional migraine prophylactic treatments have proven scarce effectiveness in VM treatment [ 5 , 6 ]. In a study by Salviz et al [ 31 ], sixty-four subjects with confirmed VM were randomly assigned to receive either propranolol (group P, n = 33) or venlafaxine (group V, n = 31) for VM prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

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Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Lovato,

Disco,

Frosolini

et al. 2023

Medicina

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Background. Monoclonal antibodies (mAbs) directed against the calcitonin gene-related peptide (CGRP) or its receptor represented the first targeted and specialized approach to migraine prophylaxis. Nevertheless, they have been rarely considered in the treatment of vestibular migraine (VM). Our aim was to evaluate the effectiveness of anti-CGRP mAbs in VM patients who did not respond to conventional migraine treatments. Methods. Consecutive VM patients treated with erenumab were considered. As a comparison, we considered the same VM patients during conventional migraine treatments (i.e., propranolol, flunarizine, or valproic acid), which were tried before mAbs therapy. Videonystagmography, the Italian version of the Dizziness Handicap Inventory (DHI) questionnaire, and migraine days over the last 3 months were evaluated in all patients before and after treatments. Results. In the present retrospective study, we included 21 female and 2 male VM patients, mean age 45.2 years. All patients underwent contrast-enhanced magnetic resonance imaging that ruled out other causes of vertigo. The DHI questionnaire significantly improved after mAb therapy (p < 0.0001). Mean migraine days over the last 3 months were significantly reduced after treatment (p = 0.001). Videonystagmography was altered in 11 (48%) patients prior to monoclonal antibodies. We found vertical positional nystagmus in 9 patients and horizontal positional nystagmus in 2 patients. After the treatment, we found vertical positional nystagmus only in 1 patient (p = 0.002). When patients were treated with conventional therapies, there was no significant reduction in DHI, and instrumental vestibular examinations remained altered. Conclusions. VM patients using anti-CGRP mAbs experienced a reduction in the dizziness-derived handicap, as reported in the DHI questionnaire. Furthermore, these treatments were significantly associated with a normalization of vestibular instrumental analysis. These findings were not seen with conventional treatments. Treatment with anti-CGRP mAbs may be effective in VM patients who did not respond to conventional migraine treatments. These findings should be tested in large, randomized clinical trials.

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Section: Discussionmentioning

confidence: 99%

“…The following molecules have been mainly considered: Metoprolol, propranolol, venlafaxine, amitriptyline, flunarizine, topiramate, or valproic acid [ 5 ]. No clear recommendations for the prescription of such therapies have been made [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Lovato,

Disco,

Frosolini

et al. 2023

Medicina

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“…It gives vital input to the brain regarding where the body is, how it moves, and how it is oriented in space [ 1 - 2 ]. Vestibular dysfunction can be categorized into peripheral and central vestibular dysfunctions [ 3 ] and could significantly compromise the quality of life [ 4 ]. Some peripheral conditions include benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and labyrinthitis.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Normative Data for Objective Vestibular Tests

Swamy¹,

Yuvaraj²,

Pruthi³

et al. 2023

Cureus

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Introduction: Vestibular dysfunction is a debilitating disorder frequently encountered in neurological and otological settings. The vestibular system is a complex network between peripheral and central mechanisms. This innate complexity of the vestibular system necessitates objective test procedures for evidence-based diagnostic formulations and intervention. Objective tests aid in the evaluation of both peripheral and central vestibular pathologies. Establishing and availability of comprehensive normative data for these objective tests is crucial for clinicians and researchers alike. Materials and methods: This is a prospective study involving 120 participants (both males and females) aged between 18 and 55 years. All participants were right-handed individuals and had no significant medical history. On pre-set protocols, cVEMP (cervical vestibular evoked myogenic potential), oVEMP (ocular vestibular evoked myogenic potential), vHIT (video head impulse test), and VNG (videonystagmography) were done. Results: While all participants (n=120) underwent cVEMP, oVEMP, vHIT, saccade, smooth pursuit, and optokinetic tests, only 109 participants consented to the caloric test. Each test's mean, standard deviation, median, quartile, and third quartiles have been recorded. A right-left comparison yielded no significant difference on cVEMP, oVEMP, caloric test, smooth pursuit, and optokinetic test. However, few vHIT and saccade parameters did reveal significant differences. Discussion: This study presents comprehensive normative data for cVEMP, oVEMP, vHIT, caloric test on VNG, and oculomotor tests (smooth pursuit, saccade, optokinetic) on VNG. The test results were in concordance with previously published data. The significant difference between the right and left sides in vHIT may be because of the monocular goggles used for the testing. Conclusion: This study brings out the normative data for various vestibular tests on individuals aged between 18-55 years. This information could aid both clinicians and researchers working in the field of vestibular science.

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“…The two most common EVS are Vestibular Migraine (VM) and Meniere's Disease (MD). Clinically, VM is typically characterized by recurrent vestibular symptoms and attacks with migraine features (migraine, photophobia, phonophobia), with a prevalence of about 1%‒2.7%, 1 whereas MD as an inner ear disease is typically characterized by recurrent vestibular symptoms and audiological symptoms (fluctuating sensorineural hearing loss, aural fullness and tinnitus), with a prevalence of about 0.2%‒0.5%. 2 …”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical characteristics and vestibular function test results in patients with vestibular migraine and Menière’s disease

Wu,

Ling,

Song

et al. 2023

Brazilian Journal of Otorhinolaryngology

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Vestibular Migraine

Cited by 15 publications

References 87 publications

Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Monoclonal Antibodies Targeting CGRP: A Novel Treatment in Vestibular Migraine

Comprehensive Normative Data for Objective Vestibular Tests

Comparison of clinical characteristics and vestibular function test results in patients with vestibular migraine and Menière’s disease

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