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Vestibular rehabilitation outcomes in patients with and without vestibular migraine

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Abstract

Vestibular rehabilitation programs do appear to play a beneficial role in the treatment of dizziness in patients with vestibular migraine. Anecdotally, however, patients with vestibular migraine may report persistent significant symptoms at the end of a standard treatment period where other non-migrainous patients are accomplishing their treatment goals. Therefore, the objective of this study was to assess the efficacy of vestibular rehabilitation in patients with vestibular migraine compared to patients with vestibular symptoms without migraine. Thirty-six patients (vestibular migraine = 20, vestibular impairment = 16) with significant daily vestibular symptoms received a nine week customized vestibular rehabilitation program. Each subject attended five therapy appointments occurring at initial, two, five, nine and six months. A range of subjective and physical performance outcome measures were taken at baseline, nine weeks and six months. The vestibular migraine group showed poorer subjective performance at the onset of therapy, which was not reflected in the difference in physical performance between the groups. Both groups benefitted equally from rehabilitation. The same degree of improvement was observed in the migraine group regardless of medication regime. This study has validated vestibular rehabilitation as an effective treatment in dizzy patients both with and without vestibular migraine where the use of medication did not preclude benefit from therapy. However, further research is required to clarify the role of specific vestibular suppressant medications and the scheduling of their use in relation to physical therapy.

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Acknowledgments

This study was supported by the Royal Victorian Eye and Ear Hospital (06/704H). The authors would like to thank the staff at the Vestibular Investigation Unit for their contribution to the collection of patient data, and the manuscript reviewers for their comments.

Conflicts of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Carlton, VIC, 3053, Australia

    Jessica Vitkovic, Gary Rance & Richard Dowell

  2. Department of Audiology, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia

    Arimbi Winoto

  3. Dizzy Day Clinics, Melbourne, Australia

    Arimbi Winoto

  4. Austin Health Heidelberg, Heidelberg, Australia

    Arimbi Winoto

  5. Department of Neuro-Opthalmology, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia

    Mark Paine

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  1. Jessica Vitkovic
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  2. Arimbi Winoto
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Correspondence to Jessica Vitkovic.

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Vitkovic, J., Winoto, A., Rance, G. et al. Vestibular rehabilitation outcomes in patients with and without vestibular migraine. J Neurol 260, 3039–3048 (2013). https://doi.org/10.1007/s00415-013-7116-7

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  • DOI: https://doi.org/10.1007/s00415-013-7116-7

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