Prophylactic treatment of vestibular migraine

Prophylactic treatment of vestibular migraine

Author Salmito, Marcio Cavalcante Autor UNIFESP Google Scholar
Duarte, Juliana Antoniolli Autor UNIFESP Google Scholar
Golcalves Morganti, Ligia Oliveira Autor UNIFESP Google Scholar
Caus Brandao, Priscila Valeria Autor UNIFESP Google Scholar
Nakao, Bruno Higa Autor UNIFESP Google Scholar
Villa, Thais Rodrigues Autor UNIFESP Google Scholar
Gananca, Fernando Freitas Autor UNIFESP Google Scholar
Abstract Introduction: Vestibular migraine (VM) is now accepted as a common cause of episodic vertigo. Treatment of VM involves two situations: the vestibular symptom attacks and the period between attacks. For the latter, some prophylaxis methods can be used. The current recommendation is to use the same prophylactic drugs used for migraines, including beta-blockers, antidepressants and anticonvulsants. The recent diagnostic definition of vestibular migraine makes the number of studies on its treatment scarce. Objective: To evaluate the efficacy of prophylactic treatment used in patients from a VM outpatient clinic. Methods: Review of medical records from patients with VM according to the criteria of the Barany Society/International Headache Society of 2012 criteria. The drugs used in the treatment and treatment response obtained through the visual analog scale (VAS) for dizziness and headache were assessed. The pre and post-treatment VAS scores were compared (the improvement was evaluated together and individually, per drug used). Associations with clinical subgroups of patients were also assessed. Results: Of the 88 assessed records, 47 were eligible. We included patients that met the diagnostic criteria for VM and excluded those whose medical records were illegible and those of patients with other disorders causing dizziness and/or headache that did not meet the 2012 criteria for VM. 80.9% of the patients showed improvement with prophylaxis (p < 0.001). Amitriptyline, Flunarizine, Propranolol and Topiramate improved vestibular symptoms (p < 0.001) and headache (p < 0.015). The four drugs were effective in a statistically significant manner. There was a positive statistical association between the time of vestibular symptoms and clinical improvement. There was no additional benefit in hypertensive patients who used antihypertensive drugs as prophylaxis or depressed patients who used antidepressants in relation to other prophylactic drugs. Drug association did not show statistically significant results in relation to the use of a single drug. Conclusions: Prophylactic medications used to treat VM improve the symptoms of this disease, but there is no statistically significant difference between the responses of prophylactic drugs. The time of vestibular symptom seems to increase the benefit with prophylactic treatment. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.
Keywords Dizziness
Vertigo
Migraine
Prophylaxis
Treatment
xmlui.dri2xhtml.METS-1.0.item-coverage Sao Paulo
Language English
Date 2017
Published in Brazilian Journal Of Otorhinolaryngology. Sao Paulo, v. 83, n. 4, p. 404-410, 2017.
ISSN 1808-8694 (Sherpa/Romeo, impact factor)
Publisher Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial
Extent 404-410
Origin http://dx.doi.org/10.1016/j.bjorl.2016.04.022
Access rights ACESSO ABERTO
Type Article
Web of Science ID WOS:000407541000006
URI https://repositorio.unifesp.br/handle/11600/53543

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