Table 4.
Management for vestibular migraine in the included studies.
| First author, year of study | Prophylactic or abortive? | Medical treatment of study | Additional management | Effect of treatment |
|---|---|---|---|---|
| Anshul et al., 2020 | Prophylactic | Mashbaladi pachana kashaya nasya (nasal administration) and pana BID for 1 month | Avoidance to dust, smoke, sunshine, anger, excess fatty and liquid diet, day sleeping, cold water | Patient reported complete relief of symptoms during 4-month follow-up period |
| El-Badry et al., 2017 | Prophylactic | 37.5-mg cinnarizine, BID or 50-mg topiramate daily | N/A | Cured positional vertigo in 92% of study group |
| Lepcha et al., 2014,a | Prophylactic | 10-mg flunarizine daily | Vestibular therapy | Frequency of vertigo differed between flunarizine treatment group and control group (p = 0.010); no difference in headache frequency and severity |
| Prakash et al., 2008,b | Both | Prophylactic 50-mg sumatriptan, 10-mg rizatriptan, 40- or 60-mg propranolol BID | N/A | Triptan was associated with reduction or resolution of vertigo symptoms; their effect on migraines is less clear |
| Abortive 50-mg sumatriptan, 10-mg rizatriptan, 500-mg paracetamol | ||||
| Prakash et al., 2009),c | Abortive | 1000-mg IV methylprednisolone, 50-mg topiramate BID, paracetamol-domperidon, 6-mg subcutaneous sumatriptan, 25-mg intramuscular promethazine | N/A | Termination or near complete resolution of vertigo |
| Prakash et al., 2021 | Both | 500-mg IV sodium valproate acutely and prophylactic 50-mg oral lamotrigine BID for 2–3 months | N/A | Patient was symptom-free for 2 years |
| Sunitha et al., 2019 | Both | Prophylactic beta blocker, flunarizine for acute attacks | N/A | N/A |
| Taghdiri et al., 2014 | Prophylactic | 37.5-mg cinnarizine tablet at night for the first 3 days, then 75-mg tablet daily for the remaining 12-week treatment period | N/A | Mean frequency of vertigo and mean frequency, duration, and intensity of migraines decreased after 3 months of cinnarizine (p < 0.001) |
| Udagatti et al., 2017 | Prophylactic | 10-mg flunarizine and/or cinnarizine and 50-mg dimenhydrinate | N/A | Patient was symptom-free for over 9 years |
Abbreviation: BID: twice a day; IV: intravenous; TID: three times a day.
A: This study was a randomized controlled trial. Both arms received 16-mg betahistine three times a day for 48 h after onset of vertigo and 1-g paracetamol for acute attacks of headaches. The treatment arm received flunarizine.
B: This study was a case series of three patients. Sumatriptan and rizatriptan were used sometimes prophylactically and sometimes abortively.
C: This study was a case series of four patients. All patients received intravenous methylprednisolone. In addition to methylprednisolone, one patient received topiramate, and another patient received paracetamol-domperidone, sumatriptan, and promethazine.