You ask. Our headache experts answer.
Migraine-associated vertigo is estimated to
occur in 25 to 35% of all migraine patients.
Commonly, the vertigo symptoms can last
longer than 24 hours. Vertigo can also be a
common symptom of Meniere Disease, but
usually the vertigo is of a shorter duration
than in migraine-associated vertigo cases.
After appropriate neurological testing is
completed, which can sometimes include
an MRI of the brain, audiometry, electronystagmography (ENG) and caloric testing,
migraine-associated vertigo is usually treated
in the same preventive manner as other forms
of migraine. This can include a low-tyramine
headache diet and preventive medication
therapy with medications such as tricyclic
antidepressants (amitriptyline, nortriptyline,
etc.), beta blockers (propranolol, metoprolol,
etc.), calcium channel blockers (verapamil),
and anti-epileptic medications (topiramate,
valproic acid, etc.). If one class of preventive
medications is not helping, another can be
tried to help control the dizziness. Acute
migraine treatments such as triptans or
ergotamines are generally not as effective
in controlling the dizziness, and are more
specific for acute treatment of the headache
and other symptoms associated with migraine,
such as nausea and light sensitivity.
George Nissan, D.O.
Baylor Comprehensive Headache Center
Dallas, Texas
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