Diagnosis and treatment of vestibular migraine and the state-of-the-art treatment for vestibular neuritis

Abstract

Vestibular migraine (VM), which is clinically characterized as recurrent vertigo, affects approximately 4–10% patients in outpatient clinics. However, many patients preclude precise diagnosis due to many reasons, including the non-interest of otolaryngology clinicians in headache cases because patients who visit otolaryngology clinics usually do not complain of headaches as their chief complaint. For the treatment of such patients, calcium blockers, antidepressants, anticonvulsants, and beta blockers are used as treatment options. New lines of treatment involving anti-CGRP (calcitonin gene-related peptide) injection are expected for the treatment of VM. Vestibular neuritis (VN) is characterized by the sudden occurrence of intensive vertigo, and typically the attack of such vertigo occurs only once. A meta-analysis demonstrated that oral steroids are effective in the acute stage of VN for recovering canal paralysis 1 month, but not 1-year, after the disease onset. Furthermore, vestibular rehabilitation may provide relief from dizziness and improve quality of life.