- Posted September 25, 2019
New Hope Against a 'Dizzying' Form of Migraine
People who suffer bouts of vertigo and dizziness may be suffering from a type of migraine for which treatments rarely work.
But a new, preliminary study of 18 such patients found that stimulating the vagus nerve in the neck can help relieve vertigo.
"Vestibular migraine can occur with or without headache. It's an uncomfortable feeling, an abnormal sense of motion. A lot of people say that they feel like they're spinning," explained Dr. Deena Kuruvilla, an assistant professor of neurology at Yale University.
Patients feel like they're off balance and may be nauseous. "It's an incredibly disabling disorder," said Kuruvilla, who was not involved in the study.
It's a tricky condition to diagnose, she added. "Nine times out of 10, patients get misdiagnosed," so people are best off seeing a neurologist or a headache specialist, Kuruvilla said.
However, the new treatment might help ease the condition, the authors of the new study said.
"Noninvasive vagus nerve stimulation that's approved for migraines and cluster headaches also relieves vertigo in patients with vestibular migraine," said lead researcher Dr. Shin Beh. He's an assistant professor of neurology at the University of Texas Southwestern Medical Center, in Dallas.
Stimulating the vagus nerve appears to calm down centers in the brain that cause migraine and vertigo, he explained.
Vestibular migraine is not curable, Beh said, "but this adds another possible treatment."
The stimulation is delivered via a handheld device placed against the neck during a vestibular migraine attack. The device that delivers electrical impulses to the nerve is regularly used to treat typical migraines.
Among the study participants, 14 patients were treated during a vestibular migraine attack, and four patients were treated for persistent dizziness between attacks.
After the nerve stimulation, 13 of the 14 patients had an improvement in their vertigo. In this group, two had their vertigo disappear and five experienced a 50% reduction in symptoms, the researchers found.
In addition, the five patients whose attack had an associated headache all reported less pain after the treatment.
How long the effect of the nerve stimulation lasts isn't known, Beh said. The study wasn't designed to see if nerve stimulation prevents future attacks.
It's also possible that the effect could be heightened if it's used in combination with migraine medications, he suggested.
Unfortunately, none of the patients treated for persistent dizziness between attacks experienced any improvement.
The only discomfort from the treatment was a mild pulling sensation of the neck muscles, the researchers noted.
The study is limited by its small size and the fact that all of the patients received the real treatment, so the results can't be compared with people given sham treatment, Beh said.
The findings were published online Sept. 25 in the journal Neurology.
Kuruvilla said, "I don't think the study had enough people in it to draw such a dramatic conclusion to say that each of these vertigo attacks, these dizziness attacks, are going to be completely cured with this device."
Another drawback is the cost of the device. "The monthly cost that the company has put on the device has made it really prohibitive for the majority of people," she added.
According to Kuruvilla, the monthly fees can run as high as $600, and the treatment isn't covered by insurance.
The Vestibular Disorders Association has more on vestibular migraine .
SOURCES: Shin Beh, M.D., assistant professor, neurology, University of Texas Southwestern Medical Center, Dallas; Deena Kuruvilla, M.D., assistant professor, neurology, Yale University, New Haven, Conn.; Sept. 25, 2019, Neurology, online
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