Vestibular migraine: issues of diagnosis and optimization of therapy

Abstract

Headache and dizziness are the two most common complaints with which patients turn to physicians of various specialties. A thorough examination often reveals a combination of these two symptoms. Currently, the term “vestibular migraine” (VM) is recognized by the worldwide community of otoneurologists and neurologists as the most appropriate for the combination of vestibular vertigo and migraine headaches. The difficulties in diagnosis and differential diagnosis are related to the lack of possibility to confirm the disease (and to detect) instrumentally and to the fact that the dizziness may be different in different VM episodes, even in one patient. The complexity of therapy is in the need to choose a relatively individualized treatment regimen and in the lack of an ideal vestibular suppressant (which quickly suppresses dizziness and has no significant side effects). In this context, finding the most effective drugs for emergency and elective treatment of patients with VM is undoubtedly important. For patients with VM, the use of the drug Arlevert (dimenhydrinate 40 mg + cinnarizine 20 mg) can be recommended for the relief of acute vestibular crisis at home, since the drug is highly effective and well tolerated. In addition, and most importantly, Arlevert has no known interactions with other medications used for migraine prevention.