In recent discussions it has been suggested that VRT may be hopeless for someone with migraine associated vertigo (MAV). Even Dr Rauch made a comment that when VRT fails it usually points to migraine interfering with the process of recovery. And this makes sense. How can VRT work you would think when there is some neurological process undermining everything all the time?
But here's a study that refutes the above:
| Physical Therapy for Migraine-Related Vestibulopathy and Vestibular Dysfunction With History of Migraine |
SL Whitney et al.
Laryngoscope. 2000 Sep;110(9):1528-34.
Note: They use the term MAV here for people experiencing vertigo without the headache component.
- Persons who experience migraine-related vestibulopathies often have abnormal vestibular laboratory results.
- the diagnosis of MAV is often a diagnosis of exclusion after other vestibular and central nervous system diseases have been ruled out. Use of medication and control of dietary triggers is often helpful in the control of MAV.
- The purpose of this retrospective chart review was to determine the efficacy of physical therapy for patients with a diagnosis of MAV and migraine headache. There is no evidence in the literature that persons with MAV and migraine headache improve functionally with physical therapy intervention.
- 39 patients were identified through a retrospective chart review, 14 with a diagnosis of MAV and 25 with migraine headache. The patients were treated with a custom-designed physical therapy exercise program for a mean of 4.9 visits over a mean duration of 4 months.
- Abnormal caloric responses were demonstrated by 55% of the patients, rotational vestibular test results were abnormal in 42% of the patients, oculomotor test results were abnormal in 29% of the patients, and positional test results were abnormal in 19% of the patients.
- Significant differences were seen after therapy in each of the outcome measures used. Patients with MAV and migraine headache demonstrated improvement in physical performance measures and self perceived abilities after vestibular physical therapy.
- There appears to be an improved outcome if a patient is taking an antimigraine medication in conjunction with physical therapy intervention. Only four of 39 patients referred for physical therapy were worse after intervention. After performing this retrospective study, the authors believe that physical therapy should be considered an efficacious treatment for patients with MAV. Also, a history of migraine should not be considered a contraindication to a trial of physical therapy.
Best ... Scott