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Migrainous vertigo (MV) is a frequent vestibular syndrome, but current evidence for both acute1-3⇓⇓ and prophylactic1,3,4⇓⇓ treatment consists only of a few uncontrolled case reports on the successful use of migraine medication. Vestibular suppressants such as promethazine, dimenhydrinate, and meclizine often reduce but do not abort vertigo and have sedating side effects. There is anecdotal evidence that sumatriptan may be effective.2,5⇓ To evaluate the effect of an oral triptan on acute MV we chose zolmitriptan, which is less hydrophilic than sumatriptan, thus facilitating CNS penetration.
Methods.
This study was a randomized, double-blind, placebo-controlled, crossover-after-one-attack trial of 2.5 mg oral zolmitriptan for treatment of acute migrainous vertigo.
Criteria6 for MV were (1) episodic vestibular symptoms of at least moderate severity (rotational vertigo, other illusory self or object motion, positional vertigo or head motion intolerance, i.e., sensation of imbalance or illusory motion provoked by head movements). Vestibular symptoms were “moderate” if they interfered with but did not prohibit daily activities, “severe” if patients could not continue daily activities; (2) current or …
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