How to treat a vestibular migraine?
Only a few clinical studies have been conducted on the specific treatment of vestibular migraine : during the crisis or in prophylaxis, that is to say in the background treatment of migraine .
Triptans to treat vestibular migraine
Two of these studies investigated the use of triptans for the treatment of seizures . Unfortunately, the validity of the first study is limited due to the small number of patients (n=10), who reported only 17 seizures. The second study had a more robust methodology but did not conclude on the pain of the migraine attack. This study only shows triptan (rizatriptan) reduces motion sickness. As none of the studies available to date are sufficient, most treatment recommendations for the prophylactic treatment of vestibular migraine today are based on treatment guidelines for migraine with and without aura .
Migraine treatments that are effective in vestibular migraine
A large evaluation of 100 patients compared patients with vestibular migraine with and without migraine prophylaxis treatment . All patients on treatment showed a reduction in the duration, intensity and frequency of vertigo and its associated characteristics.Medications taken were: metoprolol or propranolol, valproic acid, topiramate, butterbur extract , lamotrigine, amitriptyline, flunarizine, or magnesium .
Smaller cohorts have reported the effects of single medications for migraine prophylaxis. Sodium valproate did not relieve vestibular symptoms in a group of 12 patients with vestibular migraine, but had a significant effect on migraine headache in eight of them. Cinnarizine was tested in an open-label study in vestibular migraine and migraine associated with dizziness. The study involved 24 patients with vestibular migraine (23 women, 1 man) and 16 patients with basilar migraine (12 women, 4 men). The average frequency of vertigo as well as the average frequency, duration and intensity of migraines per month were significantly reduced after 3 months of treatment with cinnarizine.
No specific treatment
There is no specific treatment for vestibular migraines. Sometimes it is necessary to act on the symptoms of vestibular migraine . The use of meclozine or other abortifacient drugs that suppress the vestibular system should be kept to a minimum and used only occasionally as needed, such as during an episode. For frequent attacks , the doctor may recommend one or more of these medications, as well as others:- Beta-blockers
- Calcium channel blockers
- Tricyclic antidepressants
- Serotonin or serotonin/norepinephrine reuptake inhibitors (SSRIs or SNRIs)
- Topiramate
Natural cure for vestibular migraine
People with vestibular migraines can reduce the number and intensity of episodes by maintaining a regular sleep and eating schedule, avoiding triggers , exercising regularly, and managing stress .Feverfew and white willow are often beneficial. The HERBA Mig food supplement or the MIG SPRAY medical device have shown effectiveness after 3 months of treatment.
Therefore, knowing the triggers for headaches can help avoid dizziness associated with migraines. Elements like chocolate, cheese, alcohol, red wine ... can be triggering factors. If you suffer from vestibular migraines, these foods may also trigger your symptoms. You can try removing them from your diet to see if your symptoms improve a little. Tracking your diet is another good way to know if your dizziness symptoms are really due to headaches. For example, a diet high in salt may make vertigo symptoms worse if you have Ménière's disease . Keep a food diary and show it to your doctor. It can help improve your diagnosis and treatment.
