Diagnosis and principles of vertigo therapy in patients with migraine
Filatova E.G., Ivanova T.A.

Sechenov University, Moscow

Aim: to determine the nature of vertigo in patients with migraine with and without aura, and to substantiate approaches to their therapy.
Patients and Methods: the study enrolled 152 patients aged from 18 to 65 years with a diagnosis of migraine with and / or without aura. The patients with neurological and / or internal diseases, blood disorders, accompanied by dizziness and imbalance, were excluded from the study. Patients’ examination included clinical neurological, otoneurological examination, hospital anxiety and depression score (HADS), anxiety sensitivity index (ASI), dizziness handicap index (DHI), otoneurological questionnaire.
Results: it was shown that 58.6% of patients had complains on vertigo. The most common type detected with migraines was psychogenic vertigo, which is a symptom of an anxiety disorder. It has been shown that anxiety sensitivity plays a decisive role in its pathogenesis. We diagnosed vestibular, systemic vertigo, caused by migraine, in 13.9% of cases. It was revealed mainly in patients with chronic migraine. The positional character of vertigo was also noted (increase in the DHIP subscale), and one of the diagnostic criteria was reducing vertigo during a migraine attack by the use of tryptans, which is characteristic of the peripheral vestibulopathy. Verigo due to migraine caused by various diseases of the peripheral vestibular apparatus (BPPV, Meniere’s disease, vestibular neuronitis) was rarely observed during our study — in 2.6% of cases.
Conclusion: correct and early diagnosis of functional vertigo with migraine is important to prevent further chronicization of the disease and to provide adequate treatment and improve the quality of life of patients with migraine. If there are signs of subclinical vestibulopathy in migraine, it is advisable to use a complex treatment: a combination of etiotropic therapy with symptomatic treatment aimed at reducing the excitability of the vestibular apparatus. For this purpose it is possible to use a homeopathic multicomponent drug Vertigoheel, which provides a symptomatic treatment of vertigo of various origin.

Key words: migraine, vertigo, headache, treatment of vertigo, vestibular vertigo, Vertigoheel.
For citation: Filatova E.G., Ivanova T.A. Diagnosis and principles of vertigo therapy in patients with migraine // RMJ. 2018. № 4(II). P. 55–59.