Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida.
Laryngoscope. 2021 Jan;131(1):186-194. doi: 10.1002/lary.28546. Epub 2020 Feb 21.
To assess the efficacy of the various therapies used for the prevention of vestibular migraine (VM).
Primary studies were identified though PubMed, Scopus, PsycINFO, and Cochrane Library by two independent investigators for articles published through April 2019. The search identified randomized comparison or observational studies pertaining to vestibular migraine treatment. Meta-analysis was performed on pre- and posttreatment Dizziness Handicap Inventory, vertigo frequency, and percentage of perceived improvement.
Literature search identified 13 studies that reported sufficient outcome measures to be included in the analysis. Patients with VM had a mean age of 43.3 years with female-to-male gender ratio of 2.1:1. Classes of therapeutic agents included antiepileptic drugs, calcium channel blockers, tricyclic antidepressants, β-blockers, serotonin and norepinephrine reuptake inhibitors, and vestibular rehabilitation. All treatment options that were analyzed demonstrated improvement in all of the outcome parameters, but due to significant heterogeneity and lack of standardized reporting on outcomes, establishment of preferred treatment modality could not be determined.
Various treatment modalities have been evaluated for preventative treatment of VM. Physician familiarity, patient comorbidities, and the side-effect profiles of various interventions likely influence the selection of intervention. Future randomized controlled trials with restrictive inclusion criteria and generalizable standardized outcome measures will allow for more robust meta-analyses and for more evidence-based treatment of vestibular migraines. Laryngoscope, 131:186-194, 2021.
评估各种用于预防前庭性偏头痛（VM）的疗法的疗效。
通过两名独立研究者在 PubMed、Scopus、PsycINFO 和 Cochrane Library 上进行初步研究，以查找截至 2019 年 4 月发表的与前庭性偏头痛治疗相关的随机对照或观察性研究。对眩晕障碍量表（Dizziness Handicap Inventory）、眩晕频率和感知改善百分比的治疗前后数据进行荟萃分析。
文献检索确定了 13 项研究，这些研究报告了足够的结局指标，可纳入分析。VM 患者的平均年龄为 43.3 岁，女性与男性的性别比为 2.1:1。治疗药物类别包括抗癫痫药、钙通道阻滞剂、三环类抗抑郁药、β 受体阻滞剂、5-羟色胺和去甲肾上腺素再摄取抑制剂以及前庭康复。所有分析的治疗选择均显示所有结局参数均有所改善，但由于存在显著的异质性和结局报告缺乏标准化，因此无法确定首选治疗方法。
已经评估了各种治疗方法来预防 VM。医生的熟悉程度、患者的合并症以及各种干预措施的副作用特征可能会影响干预措施的选择。未来具有严格纳入标准和可推广的标准化结局指标的随机对照试验将允许进行更强大的荟萃分析，并为前庭性偏头痛的治疗提供更多循证依据。喉镜，131:186-194，2021。
