A new treatment for motion sickness in patients with migraines was reported by a group of doctors from Pittsburgh. Giving migraine sufferers who are prone to motion sickness a migraine drug, rizatriptan (Maxalt) prevented motion sickness . There were 25 subjects in the study and 15 of them developed motion sickness after being rotated in the darkness. Of these 15 patients, 13 showed decreased motion sickness after being pretreated with rizatriptan. This was a small study and not all patients benefited, but this is an option that should be considered in patients who suffer from severe motion sickness. It is likely that the effect is not specific to rizatriptan, but that sumatriptan (Imitrex), eletriptan (Relpax) and other triptans are also effective. However, just like when treating migraine attacks, it is possible that some patients will respond better to one triptan and others to another.
Read MoreVertigo is a common complaint of migraine patients. Ear-nose-throat specialists at the University of Pisa examined 22 patients with migraine headaches who complained of vertigo and 22 who did not, as well as 22 control subjects without migraines. They found that in both groups of patients with migraines a third had abnormal vestibular function on laboratory testing. In half of the patients in both groups the abnormality was in the inner ear (peripheral dysfunction) and in half in the brain (central dysfunction). This study confirms that both central and peripheral vertigo are common in migraine patients, whether they complain of vertigo or not. The most important question patients ask is what can we do about it. Fortunately, once migraines are brought under control, vertigo also subsides.
Read MoreMigrainous vertigo seems to respond to intravenous infusion of a high dose of corticosteroids, according to a report in the latest issue of Headache by a group of Indian doctors. Two of their patients had intermittent episodes of severe vertigo and two had chronic vertigo. All four respond to infusions of 1 gram of methylprednisolone. One require 3 infusions, one needed 2 and in another 2 vertigo stopped after a single infusion. We routinely use corticosteroids for severe migraine attacks when other medications fail. While occasional (once or twice a month) use of corticosteroids is relatively safe, frequent or daily intake of corticosteroids (besides methylprednisolone, these drugs include prednisone, prednisolone, and dexamethasone) can lead to dangerous side effects. It is possible that oral corticosteroids will produce a similar effect as an infusion and may be worth trying when nothing else helps relieve the vertigo.
Read MoreVertigo can induce a migraine attack in migraine sufferers, according to a study published in Neurology. In this study researchers induced vertigo in patients who had a history of migraines and in a control group. Almost half of those who had a history of migraines developed a migraine attack within 24 hours, compared with only 5% of those who were not known to have migraines. The study suggests that vertigo due to an inner ear problem can trigger a migraine attack. This finding will not come as a surprise to migraine sufferers who cannot ride a roller coaster or even go on bumpy a car ride without getting a migraine.
At times, migraine sufferers develop vertigo as part of their migraine attack and it can be difficult to tell if vertigo caused the migraine or was just one of the symptoms. A detailed description of more than one attack usually gives a clear answer.
Read MoreVertigo is a common symptom in patients with migraine headaches. It appears that obverse is also true – migraine is very common in patients with vertigo. A study just published in Cephalalgia looked at 208 patients with benign recurrent vertigo. It turned out that 87%, or 180 of these patients had migraine headaches. Of these 180 patients, 112 or 62% had migraine with aura and 38% had migraine without aura. Thirty percent, or 54 patients always had vertigo without any migraine symptoms, while in 70% vertigo occurred with a headache or other migraine symptoms, such as visual aura, sensitivity to light and noise. The duration of attacks of vertigo in most patients was between one hour and one day.
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