Migraine prophylactic treatment, which is effective in the treatment of vestibular migraine
CGRP antibody injection can prevent vestibular migraine with CGRP receptors distributed in the vestibular nerve of the inner ear
– What is a vestibular migraine?
In simple words, among the different types of migraine, it can be understood as “migraine accompanied by regular dizziness.” In 2012, the Barany society, a global group of experts dealing with dizziness, and the International Classification of Headache Disorders (ICHD) in 2013 classified ‘vestri migraine’ as an independent disease and established its published diagnostic criteria. The content is as follows.
▲ Do you have vestibular symptoms of moderate severity lasting between 5 minutes and 72 hours ▲ Do you have a history of typical migraine that meets the criteria for a migraine diagnosis from the International Classification of Headache Disorders ▲A you have persistent dizziness symptoms of 5 or more occurrences (meeting the above requirements) ▲ About 50% or more of vestibular seizures meet one or more of the typical migraine features. (Typical migraine characteristics: △ throbbing pain on one side only, △ throbbing and throbbing △ pain of more than moderate severity, making it impossible to carry out daily activities △ hypersensitivity to sight or hypersensitivity to hearing, etc.)
– What is the difference between vestibular migraine and dizziness due to otolithiasis?
Benign paroxymal positional vertigo (BPPV), also known as otolithiasis, is the most common cause of vertigo, but vestibular migraine is known to be the most common cause of recurrent spontaneous vertigo.
There is dizziness that goes round and round on waking in the morning, dizziness due to positional changes, no symptoms in the ears or other parts, short attack duration, and dizziness that gets better when you stay still and gets worse when moving are typical symptoms of otolithiasis. This is because degenerating glass otoliths in the ear cause dizziness whenever they move, and otolithiasis tends to recur once it occurs.
Vestibular migraines show symptoms of non-specific vertigo, and as mentioned above, there is a history of migraine disease, and it can be caused by lack of sleep or excessive stress. In the case of vestibular migraine in children, recurrent abdominal pain may occur as well as recurrent dizziness. Vestibular migraines also tend to recur.
Although the two diseases can be easily distinguished through a medical examination, it is important to get a correct diagnosis through a specialist because the treatment is completely different.
– Sedative migraine treatments, what are they?
Treating a vestibular migraine is not much different from treating a common migraine.
Migraine treatment includes △acute treatment to relieve symptoms after pain occurs and △preventive treatment to treat migraine by prevention before pain occurs.
Acute phase treatment includes taking general pain relievers such as acetaminophen or acute phase medications such as triptans. Preventive treatment includes taking oral preventative drugs or giving injections such as botox and CGRP antibody injection.
Until now, oral prophylactic drugs are non-migraine specific drugs, borrowing the migraine preventive effects of other disease treatments such as antidepressants, antiepileptic drugs, beta blockers, and calcium channel blockers. Although it is effective in preventing migraines, there are many concerns about side effects, the downside being that it takes a long time to see the effect because the dose is used in small amounts and then increases gradually.
CGRP antibody injection is a migraine-specific drug that targets the inhibition of CGRP (calcitonin gene-related peptide), a key factor in migraines Coordination is good.
– Migraines, why is preventive treatment important?
Although acute treatment may relieve symptoms, it does not reduce the frequency or intensity of subsequent headaches. In addition, acute medications can cause medication overuse headache (MOH) if taken in excess. Medication overuse headache is very difficult to treat once it occurs, and it is very difficult to stop taking the medication. Preventive treatment can be a good option as a way to prevent overuse of medication in chronic migraine patients.
△If you have a headache for more than 15 days a month, △If you have a headache more than 2 times a month, and everyday life is difficult because of a headache of more than moderate or severe severity, △Intermittent medications acute ineffective, or △Acute phase medications cannot be taken due to side effects, etc. In some cases, preventive treatment is recommended.
– Are oral preventive medications effective for vestibular migraine?
Topiramate, Depakort, and calcium channel blockers, known to be effective for chronic migraine, are known to have some effect on vestibular migraine. Triptans, an acute treatment, are also known to relieve dizziness along with headache.
– What is the treatment effect of CGRP antibody injection therapy for vestibular migraine?
There is a great deal of theoretical evidence that CGRP antibody injections are effective for vestibular migraine.
Among the various neurotransmitters that are secreted when the trigeminal nerve near the membrane of our brain is stimulated, CGRP is the key factor that causes migraines. Injection of CGRP antibody prevents headaches by preventing the binding of these CGRP receptors. CGRP receptors are distributed not only in the trigeminal nerve but also in the vestibular nerve of the inner ear (which causes dizziness).
Therefore, if CGRP is controlled by injection of CGRP antibody, it is expected that headache and dizziness can be controlled.
I personally see good effects when CGRP antibody injection treatment is given to chronic vestibular migraine patients who do not respond to other treatments. Although clinical data on CGRP antibody injection treatment for vestibular migraine is still lacking, various international clinical studies are being conducted and related studies are underway in Korea, so it may be a good option for treating patients with refractory vestibular migraine.
– What lifestyle habits prevent migraine-induced dizziness?
Basically, lifestyle habits that prevent headaches also help prevent vestibular migraines. Avoid excessive stress, and recommend proper exercise and regular sleep.
It is also good to avoid prolonged exposure to smartphones or tablet computers. This is because prolonged exposure to light in a sleep-deprived state can cause migraine headaches.
Above all, you need to take a good look at what situations trigger your migraine or dizziness, and make an effort to prevent such situations from being created.
