Introduction: Migraine is the third most common disease in the world with an estimated prevalence of 14.7%. The purpose of this study was to identify the characteristic changes in cervical and ocular vestibular evoked myogenic potential (VEMP) and analyse changes in symptoms and VEMP after flunarizine therapy in patients diagnosed with vestibular migraine (VM). Methods: Prospective interventional study was conducted on 31 VM patients. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were recorded. Flunarizine (10 mg) was given once daily for two consecutive months. Prophylactic therapy was monitored with a monthly follow-up assessment of their symptoms and VEMP was repeated after 2 months. Results: Headache was the chief complaint (67.7%). Vertigo was spontaneous and mostly moderate in intensity (93%). cVEMP was absent in 1 patient and oVEMP was absent in 3 patients. Post prophylactic treatment with flunarizine, there was significant reduction in the frequency (p = 0.001) and duration (p = 0.001) of headache and frequency (p = 0.001), duration (p = 0.001), and intensity (p = 0.009) of vertigo. cVEMP and oVEMP showed no significant differences (p > 0.05) between pre- and post-treatment recordings. Conclusion: Treatment with flunarizine helps in considerably reducing the episodes and duration of headache, as well as episodes, duration, and intensity of vertigo.

1.
Byun
YJ
,
Levy
DA
,
Nguyen
SA
,
Brennan
E
,
Rizk
HG
.
Treatment of vestibular migraine: a systematic review and meta-analysis
.
Laryngoscope
.
2021
;
131
(
1
):
186
94
.
2.
Çelik
O
,
Tanyeri Toker
G
,
Eskiizmir
G
,
İncesulu
A
,
Şahin Süyür
N
.
The effectiveness of medical prophylactic treatment on vestibular migraine and its effect on the quality of life
.
J Int Adv Otol
.
2020
;
16
(
1
):
28
33
.
3.
Colombo
B
,
Teggi
R
NIVE Project
.
Vestibular migraine: who is the patient
.
Neurol Sci
.
2017
38
Suppl 1
107
10
.
4.
Fujimoto
C
,
Kamogashira
T
,
Takenouchi
S
,
Kinoshita
M
,
Sugasawa
K
,
Kawahara
T
.
Utriculo-ocular pathway dysfunction is more frequent in vestibular migraine than probable vestibular migraine
.
J Neurol
.
2020
;
267
(
8
):
2340
6
.
5.
Jomin
G
,
Kumar
K
,
Ebenezer
A
.
Comparison of vestibular evoked myogenic potential and dizziness handicap inventory in patient with peripheral vestibular lesions between pre and post vestibular rehabilitation
.
Int Tinnitus J
.
2019
;
23
(
2
):
69
73
.
6.
Khalil
LH
,
Hazzaa
NM
,
Nour
AA
.
Vestibular migraine: a correlation study between clinical findings and vestibular evoked myogenic potentials (VEMPs)
.
Egypt J Ear Nose Throat Allied Sci
.
2016
;
17
(
1
):
11
6
.
7.
Liu
F
,
Ma
T
,
Che
X
,
Wang
Q
,
Yu
S
.
The efficacy of venlafaxine, flunarizine, and valproic acid in the prophylaxis of vestibular migraine
.
Front Neurol
.
2017
;
8
:
524
.
8.
Makowiec
KF
,
Piker
EG
,
Jacobson
GP
,
Ramadan
NM
,
Roberts
RA
.
Ocular and cervical vestibular evoked myogenic potentials in patients with vestibular migraine
.
Otol Neurotol
.
2018
;
39
(
7
):
e561
7
.
9.
Headache Classification Committee of the International Headache Society IHS
Bes
A
,
Kunkel
R
,
Lance
JW
,
Nappi
G
,
Pfaffenrath
V
.
The international classification of headache disorders, 3rd edition (beta version)
.
Cephalalgia
.
2013
;
33
(
9
):
629
808
.
10.
Özdemir
D
,
Akpınar
ÇK
,
Küçüköner
Ö
,
Mehel
DM
,
Bedir
A
,
Akgül
G
.
Vestibular evoked myogenic potential (VEMP) results in migraine and migrainous vertigo
.
Acta Otolaryngol
.
2020
;
140
(
2
):
140
3
.
11.
Tedeschi
G
,
Russo
A
,
Conte
F
,
Laura
M
,
Tessitore
A
.
Vestibular migraine pathophysiology: insights from structural and functional neuroimaging
.
Neurol Sci
.
2015
36
Suppl 1
37
40
.
12.
Van Ombergen
A
,
Van Rompaey
V
,
Van de Heyning
P
,
Wuyts
F
.
Vestibular migraine in an otolaryngology clinic: prevalence, associated symptoms, and prophylactic medication effectiveness
.
Otol Neurotol
.
2014
;
36
:
133
8
.
13.
von Brevern
M
,
Lempert
T
.
Vestibular migraine: treatment and prognosis
.
Semin Neurol
.
2020
;
40
(
1
):
083
6
.
14.
Zaleski
A
,
Bogle
J
,
Starling
A
,
Zapala
DA
,
Davis
L
,
Wester
M
.
Vestibular evoked myogenic potentials in patients With vestibular migraine
.
Otol Neurotol
.
2015 Feb
36
2
295
302
.
15.
Zaleski-King
A
,
Monfared
A
.
Vestibular migraine and its comorbidities
.
Otolaryngol Clin North Am
.
2021
;
54
(
5
):
949
58
.
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