What abortive and preventative treatments have you found to be helpful for a vestibular migraine?
If a patient progresses from discrete episodes (hours long) of mild vertigo with rare headaches, but associated migrainous features (photophobia and nausea) to chronic daily dizziness with occasional episodes of worsening and photophobia, does this still represent vestibular migraine or another condition such as persistent postural perceptual dizziness (PPPD)?
2 Answers
Mednet MemberInvited Expert
Neurology · Barrow Neurological Institute
Answered on
I still treat using the same medication guidelines as for any migraine presentation. I am more likely to try venlafaxine in these patients. For off-label/guidelines, I am also more likely to try gabapentin and acetazolamide. In addition to pharmacologist management, I have a low threshold to refer f...
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Mednet MemberInvited Expert
Neurology · Greater Boston Headache Center at Boston Advanced Medicine
Answered on
If vestibular migraine is indeed an entity, of which I am by far convinced, the pharmacotherapy aligns with general migraine management. This includes triptans and gepants for abortive treatment and gepants along with CGRP antibodies for preventive measures. The objectives are to achieve complete he...
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