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Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial

  • Otology
  • Published:
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Abstract

Migrainous vertigo is a common cause of dizziness presenting to an otorhinolaryngology/otoneurology clinic. Although it causes a substantial burden to the individual and society there are no randomized controlled trails on prophylactic medication for this condition. Flunarizine, a calcium channel blocker has been used effectively in both migraine and vestibular conditions. This randomized control trial was undertaken in a tertiary academic referral center to evaluate the efficacy of flunarizine in patients with migrainous vertigo when compared to non-specific vestibular treatment of betahistine and vestibular exercises. The effect of flunarizine on two particularly disabling symptoms of vertigo and headache was studied. A total of 48 patients who were diagnosed with definitive migrainous vertigo completed the study of 12 weeks duration. Patients in arm A received 10-mg flunarizine daily along with betahistine 16 mg and paracetamol 1 gm during episodes, and arm B received only betahistine and paracetamol during episodes. Symptom scores were noted at the start of the study and at the end of 12 weeks. Analysis of the frequency of vertiginous episodes showed a significant difference between arm A and arm B (p = 0.010) and improvement in severity of vertigo between the two groups (p = 0.046). Headache frequency and severity did not improve to a significant degree in arm A as compared to arm B. The main side effects were weight gain and somnolence and this was not significantly different between the two groups. Flunarizine (10 mg) is effective in patients with migrainous vertigo who suffer from considerable vestibular symptoms.

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Acknowledgments

The authors would like to gratefully acknowledge the contributions of Professor Vinohar Balraj and Ms. Visali in the statistical analysis of this article. This study was supported by funding from the Fluid Research Grants, CMC Research, Vellore.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of ENT, Unit IV, Christian Medical College and Hospital, Vellore, 632004, Tamilnadu, India

    Anjali Lepcha, Ann Mary Augustine, Amit Kumar Tyagi & Achamma Balraj

  2. Department of ENT, Indira Gandhi Medical College and Research Institute, Puducherry, 605609, India

    Sophia Amalanathan

Authors
  1. Anjali Lepcha
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  2. Sophia Amalanathan
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  3. Ann Mary Augustine
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  4. Amit Kumar Tyagi
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  5. Achamma Balraj
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Corresponding author

Correspondence to Anjali Lepcha.

Appendix

Appendix

This questionnaire was based on a similar one used for a previous study of vestibular deficits among clinically defined subgroups of patients with both migraine and vertigo attending tertiary referral neuro-otology clinics. (By AB under the guidance of Dr Ros Davis and Prof Goadsby in National hospital for Neurology and Neurosurgery, Queens Square, London, submitted as partial fulfilment of the requirements for MSc. in Audiological Medicine, University College London.)

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Lepcha, A., Amalanathan, S., Augustine, A.M. et al. Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial. Eur Arch Otorhinolaryngol 271, 2931–2936 (2014). https://doi.org/10.1007/s00405-013-2786-4

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  • DOI: https://doi.org/10.1007/s00405-013-2786-4

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