EFFICACY OF ANTI MIGRAINOUS THERAPY IN THE TREATMENT OF VERTIGO & NEURO-OTOLOGICAL SYMPTOMS OF MIGRAINE

Background: The association between hearing and balance disorders with migraine is known since the times of the ancient Greeks,when Aretaeus from Cappadocia in 131 B.C, made an accurate and detailed description of this occurrence during a migraine episode.      Yet      to      this      day,      the      condition      remains      widely      under-diagnosed      and      poorly      treated. Objective: To study the efficacy of anti-migrainous therapy in the treatment of vertigo and neuro-otological symptoms of migraine Methodology: This observational study, was conducted upon a sample of 377 migraine patients (chosen via non-probability – consecutive sampling) diagnosed according to the International Headache Society – IHS Criteria, presenting with complaint of vertigo (corresponding to the criteria of definite or probable migrainous vertigo) and other neuro-otological manifestations of migraine to the medical outpatient department of Abbasi Shaheed Hospital. The study was carried out from February 5, 2018 to August 31, 2018. Data obtained was analyzed using SPSS version 21.0 and MS. Excel 2013.Results: Out of 377 participants 121 were males and 256 were females, with a mean age of 31 years for males and 23 years for females. 48 patients reported vertigo as a classical aura symptom, 96 claimed to have experienced vertigo during and 186 independently or just during their headache episodes. 47 patients only experienced vertigo independently of the headaches. The quality of the vertigo was variable. 38 had spinning vertigo, the most common symptom was episodes of non-spinning dizziness with instability while walking (204) followed by positional vertigo (135). Nausea accompanying the vertigo was only reported by 9 patients and occasional vertigo associated falls by 6 patients. The duration of the vertigo episodes had a wide range from minutes to hours with a mean value standing at 23 minutes. Other symptoms included phono-phobia (23) and tinnitus (17).Conclusion: A careful evaluation of the results revealed that while routine anti-migrainous therapy is effective for controlling headache, the episodes of vertigo and other associated neuro-otological symptoms persisted nonetheless. Thus options such as switching     to     targeted     medication     such     as     lamotrigine     for     vestibular     complaints     should     be     explored.

Keywords: Migraine, Vertigo, Tinnitus, Anti-Migrainous Therapy & Neuro-Otological Symptoms.