Vestibular migraine (VM) management for an ENT surgeon - an update on diagnostic criteria and current management strategies

Overview: Vestibular migraine is a very common problem needing attention as it’s a diagnosis frequently missed. This article discusses key diagnostic indicators including ID-migraine, motion sickness, phono/photophobia. Key management options including prophylactic and abortive medications are also discussed.

Findings: Using of the 3 item ID-Migraine questionnaire increases sensitivity. There is no RCT evidence that Nutraceuticals usage, restriction of MSG Caffeine Chocolates, artificial sweeteners, processed meats, alcohol and aged cheese are useful in management VM. Although beta blockers are used as prophylaxis, metoprolol may not be effective.The mainstay of abortive management is 5HT receptor agonists.

Recommendations: It is necessary to raise the awareness of the diagnostic entity and necessary training and education should be given to care givers. Future research is necessary to identify therapeutic agents and lifestyle changes specifically to be effective in this condition.