Can verapamil be effective in controlling vertigo and headache attacks in vestibular migraine accompanied with Meniere’s disease? A preliminary study

  • Isa Kaya
  • Sevinc Eraslan
  • Ceyda Tarhan
  • Cem Bilgen
  • Tayfun Kirazli
  • Figen Gokcay
  • Hale Karapolat
  • Nese CelebisoyEmail author
Letter to the Editors

Dear Sirs,

Several studies have pointed to an association between migraine, vestibular migraine (VM) and Meniere’s Disease (MD) [1, 2, 3, 4, 5, 6, 7]. Though the underlying link is not clear they seem to be parts of a broad spectrum disorder [5] and can share a common genetic basis to confer susceptibility [2]. “VM/MD overlapping syndrome” diagnosis has been proposed for patients presenting with simultaneous symptoms/signs of VM and MD [7].

Depending on clinical similarities with episodic ataxia type 2 and familial hemiplegic migraine, voltage-dependent calcium channel gene (CACNA1A) mutations have been searched in patients with VM, but could not be identified [8, 9]. Potassium channel mutations [10] and the role of aquaporins in inner ear water homeostasis [11] have been speculated in MD pathophysiology.

Based on these speculations, we tried to analyze the efficacy of verapamil, a calcium channel blocker in controlling vertigo and headache attacks of patients with VM associated with...


Compliance with ethical standards

Conflicts of interest

No conflict of interest.

Ethical standards

All procedures were performed in accordance with the ethical standards stated in the Declaration of Helsinki and its later amendments.


  1. 1.
    Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H (2002) Migraine and Ménière’s disease Is there a link? Neurology 59:1700–1704CrossRefGoogle Scholar
  2. 2.
    Cha YH, Kane MJ, Baloh RW (2008) Familial clustering of migraine, episodic vertigo, and Meniere’s disease. Otol Neurotol 29:93–96CrossRefGoogle Scholar
  3. 3.
    Brantberg K, Baloh RW (2011) Similarity of vertigo attacks due to Meniere’s disease and benign recurrent vertigo, both with and without migraine. Acta Otolaryngol 131:722–727CrossRefGoogle Scholar
  4. 4.
    Neff BA, Staab JP, Eggers SD, Carlson ML, Schmitt WR, Van Abel KM, Worthington DK, Beatty CW, Driscoll CL, Shepard NT (2012) Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere’s disease, vestibular migraine, and Meniere’s disease with concomitant vestibular migraine. Otol Neurotol 33:1235–1244CrossRefGoogle Scholar
  5. 5.
    Lopez-Escamez JA, Dlugaiczyk J, Jacobs J, Lempert T, Teggi R, von Brevern M, Bisdorff A (2014) Accompanying symptoms overlap during attacks in Menière’s Disease and vestibular migraine. Front Neurol 5:265CrossRefGoogle Scholar
  6. 6.
    Ghavami Y, Mahboubi H, Yau AY, Maducdoc M, Djalilian HR (2016) Migraine features in patients with Meniere’s disease. Laryngoscope 126:163–168CrossRefGoogle Scholar
  7. 7.
    Murofushi T, Tsubota M, Kitao K, Yoshimura E (2018) Simultaneous presentation of definite vestibular migraine and definite Ménière’s disease: overlapping syndrome of two diseases. Front Neurol 9:749CrossRefGoogle Scholar
  8. 8.
    Von Brevern M, Ta N, Shankar A, Wieste A, Siegel A, Radtke A, Sander T, Escayg A (2006) Migrainous vertigo: mutation analysis of the candidate genes CACNA1A, ATP1A2, SCN1A, and CACNB4. Headache 46:1136–1141CrossRefGoogle Scholar
  9. 9.
    Kim JS, Yue Q, Jen JC, Nelson SF, Baloh RW (1998) Familial migraine with vertigo: no mutations found in CACNA1A. Am J Med Gen 79:148–151CrossRefGoogle Scholar
  10. 10.
    Gates P (2005) Hypothesis: could Meniere’s disease be a channelopathy? Intern Med J 35:488–489CrossRefGoogle Scholar
  11. 11.
    Ishiyama G, López IA, Ishiyama A (2006) Aquaporins and Meniere’s disease. Curr Opin Otolaryngol Head Neck Surg 14:332–336CrossRefGoogle Scholar
  12. 12.
    International Headache Society Classification Subcommittee (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808CrossRefGoogle Scholar
  13. 13.
    Lopez-Escamez JA, Carey J et al (2015) Diagnostic criteria for Menière’s disease. J Vest Res 25:1–7Google Scholar
  14. 14.
    Tfelt-Hansen P, Tfelt-Hansen J (2009) Verapamil for cluster headache. Clinical pharmacology and possible mode of action. Headache 49:117–125CrossRefGoogle Scholar
  15. 15.
    Waterston J (2004) Chronic migrainous vertigo. J Clin Neurosci 11:384–388CrossRefGoogle Scholar
  16. 16.
    Haman SR, Blouin RA, McAllister RG Jr (1984) Clinical pharmacokinetics of verapamil. Clin Pharmacokinetics 9:26–41CrossRefGoogle Scholar

Copyright information

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Authors and Affiliations

  1. 1.Department of OtolaryngologyEge University Medical SchoolIzmirTurkey
  2. 2.Department of NeurologyEge University Medical SchoolIzmirTurkey
  3. 3.Department of OtolaryngologyIğdır State HospitalIğdırTurkey
  4. 4.Department of Physical Therapy and RehabilitationEge University Medical SchoolIzmirTurkey

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