Kolberg AuD Courtney, Roberts PhD Richard A, Watford Dnp Kenneth E, Picou AuD PhD Erin M, Corcoran AuD Kelley
Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, FL, USA.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Ann Otol Rhinol Laryngol. 2024 Jan;133(1):111-114. doi: 10.1177/00034894231185400. Epub 2023 Jul 18.
Vestibular migraine is a common cause of vertigo. Intervention often includes preventive and/or rescue medications. Lifestyle modifications are often used along with medications but can be used as the sole intervention. There is lack of clarity regarding the long-term benefits of these interventions.
The purpose of this study was to determine long-term effects of intervention types on dizziness in patients with vestibular migraine.
Twenty-three participants were grouped based on intervention into preventive medication plus lifestyle modifications, rescue medication plus lifestyle modifications, or lifestyle modifications only. Outcomes were determined at ~372 days post intervention by comparing pre- and post-Dizziness Handicap Inventory scores. A difference of ≥18 points was considered a change and we also evaluated change in severity scale on this measure.
Using the group mean change score, only the rescue medication plus lifestyle modification group was significantly improved at 372 days of intervention. Considering all individual participants, 30% of the participants had improvement in dizziness at this point, regardless of intervention. Fifty percent of the rescue medication plus lifestyle modification group had significant reduction in dizziness, while the preventive medication plus lifestyle modification and the lifestyle modification only groups performed similarly using this criterion. Considering change in severity category, 43% of all participants improved by at least one category. The rescue medication plus lifestyle modifications and the lifestyle modifications only groups performed similarly with 50% of their respectively groups exhibiting improvement by at least one category. Notably, there was no worsening of dizziness for any participant in the lifestyle modification only group.
Our findings suggest that improvement in dizziness is maintained at ~372days of intervention in patients with vestibular migraine. Intervention using rescue medications plus lifestyle modifications had the best outcomes, followed by lifestyle modifications only. There was no worsening in dizziness for the lifestyle modification only intervention. More work is needed to better understand intervention effects, but it is encouraging that effects are maintained at greater than one year.
前庭性偏头痛是眩晕的常见病因。干预措施通常包括预防性和/或救援性药物。生活方式的改变通常与药物一起使用，但也可作为唯一的干预措施。这些干预措施的长期益处尚不清楚。
本研究的目的是确定不同类型的干预措施对前庭性偏头痛患者头晕的长期影响。
23名参与者根据干预措施分为三组：预防性药物加生活方式改变组、救援性药物加生活方式改变组或仅生活方式改变组。通过比较干预前和干预后头晕残障量表得分，在干预后约372天确定结果。得分差异≥18分被认为有变化，我们还评估了该指标严重程度量表的变化。
使用组平均变化得分，只有救援性药物加生活方式改变组在干预372天时显著改善。考虑所有个体参与者，此时30%的参与者头晕症状有所改善，无论采取何种干预措施。救援性药物加生活方式改变组中50%的参与者头晕症状显著减轻，而预防性药物加生活方式改变组和仅生活方式改变组在这一标准下表现相似。考虑严重程度类别变化，所有参与者中有43%至少改善了一个类别。救援性药物加生活方式改变组和仅生活方式改变组表现相似，各自组中有50%至少改善了一个类别。值得注意的是，仅生活方式改变组的任何参与者头晕症状均未加重。
我们的研究结果表明，前庭性偏头痛患者在干预约372天时头晕症状持续改善。使用救援性药物加生活方式改变的干预效果最佳，其次是仅生活方式改变。仅生活方式改变的干预措施未导致头晕症状加重。需要更多研究来更好地理解干预效果，但令人鼓舞的是，效果能维持一年以上。
