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Analysis of the effectiveness of the prophylaxis of vestibular migraine depending on the diagnostic category and the prescribed drug

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

Vestibular migraine (VM) consists of recurrent episodes of vestibular symptoms that are accompanied by migraine in at least 50% of the episodes. The criteria of the Bárány Society include two diagnostic categories: “actual” vestibular migraine and probable vestibular migraine. There is a wide range of drugs that can be prescribed for the prophylactic treatment of VM, but recommendations for the selection of the most appropriate drug are currently lacking.

Objective

To measure the extent to which the prophylactic treatment of VM reduces vestibular symptoms, headache and the number of crises depending on the diagnostic category of the Bárány Society and the drug used for prophylaxis.

Material and methods

This is a multicenter prospective study. Patients with VM who presented to any of the participating centers and who subsequently met the VM criteria were prescribed one of the following types of prophylaxis: acetazolamide, amitriptyline, flunarizine, propranolol or topiramate. Patients were called back for a follow-up visit 5 weeks later. This allowed the intensity of vestibular symptoms, headache and the number of crises before and during treatment to be compared.

Results

31 Patients met the inclusion criteria. During the treatment, all the measured variables decreased significantly. In a visual analogue scale, the intensity of vestibular symptoms decreased by 45.8 points, the intensity of headache decreased by 47.8 points and patients suffered from 15.6 less monthly crises compared to the period before the treatment. No significant between-group differences were found when patients were divided based on their diagnostic category or the choice of prophylaxis prescribed to them.

Conclusion

The treatment of VM produces a reduction of symptoms and crises with no significant differences based on patients’ diagnostic categories or the choice of prophylaxis prescribed to them.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Hospital Infanta Luisa, Calle San Jacinto 87, 41010, Sevilla, Spain

    E. Domínguez-Durán

  2. Complejo Hospitalario de Jaén, Jaén, Spain

    M. A. Montilla-Ibáñez

  3. Hospital Universitario Puerta del Mar, Cádiz, Spain

    M. G. Álvarez-Morujo de Sande

  4. Hospital Universitari Joan XXIII, Tarragona, Spain

    E. Domènech-Vadillo

  5. Institud D’Investigació Sanitària Pere Virgili, Reus, Spain

    E. Domènech-Vadillo

  6. Hospital Universitario de Torrevieja, Torrevieja, Spain

    C. Bécares-Martínez

  7. Hospital Universitario Marqués de Valdecilla, Santander, Spain

    R. González-Aguado

  8. Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain

    G. Guerra-Jiménez

Authors
  1. E. Domínguez-Durán
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  2. M. A. Montilla-Ibáñez
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  3. M. G. Álvarez-Morujo de Sande
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  4. E. Domènech-Vadillo
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  5. C. Bécares-Martínez
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  6. R. González-Aguado
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  7. G. Guerra-Jiménez
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Corresponding author

Correspondence to E. Domínguez-Durán.

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None of the authors had a conflict of interest in relation with the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Domínguez-Durán, E., Montilla-Ibáñez, M.A., Álvarez-Morujo de Sande, M.G. et al. Analysis of the effectiveness of the prophylaxis of vestibular migraine depending on the diagnostic category and the prescribed drug. Eur Arch Otorhinolaryngol 277, 1013–1021 (2020). https://doi.org/10.1007/s00405-020-05802-5

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  • DOI: https://doi.org/10.1007/s00405-020-05802-5

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