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Otology/Neurotology

(133) Demography and Treatment Strategy of Vestibular Migraine in Neurotologic Perspectives

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Kuei-You Lin, MD, PhD

    visiting staff, assistant professor
    Shin Kong Wu Ho-Su Memorial Hospital
    Taipei, Taipei, Taiwan (Republic of China)

    • Senior Author(s)

  • Steven D. Rauch, MD

    Professor and Vice Chair for Clinical Research
    Mass Eye and Ear
    Boston, Massachusetts, United States

Disclosure(s):
Kuei-You Lin, MD, PhD: No relevant relationships to disclose.
Steven D. Rauch, MD: No relevant relationships to disclose.


Introduction: This study aimed to investigate the current demographical features of vestibular migraine from the neurotologic perspective with an additional attempt to decide the better treatment strategy in patients with vestibular migraine.

Methods: A total of 1285 fresh dizzy cases were reviewed from Dec. 2020 to Apr. 2022. The fresh cases with a diagnosis of either vestibular migraine, Ménière’s disease, benign paroxysmal positional vertigo, or vestibular neuritis/labyrinthitis were selected for comparisons of the disease demographics. On the other hand, patients with vestibular migraine receiving follow-up visits were included in the treatment strategy analysis.

Results: Vestibular migraine appeared as the most common (25%) and youngest (47 years) diagnosis in the fresh dizzy group. Besides, vestibular migraine patients showed an obvious female preponderance of approximately 3.3:1. Furthermore, the prevalence of vestibular migraine significantly declined from 69%, 34%, to 11% in age groups of ≤ 30 years, 31-60 years, and > 60 years, respectively. Regarding the treatment strategy in patients with vestibular migraine, women aged over 45 years responded to trigger management significantly better than those aged under 45 years.

Conclusions: In a tertiary referral neurotologic center, vestibular migraine would be the most common diagnosis in dizzy patients aged under 60 years, especially in women. Regarding the treatment for vestibular migraine, trigger management should be considered as the entry-level treatment because it could provide an acceptable rate of symptom control.