Objective To assess the efficacy and safety of cinnarizine for the prophylaxis of migraine associated vertigo in the vestibular migraine and migraine with brainstem aura. Background Vestibular migraine and migraine with brainstem aura are two principal clinical syndromes that frequently are associated with vertigo. Since cinnarizine is a well-tolerated calcium channel blocker which has They also should not be used in patients who have hemiplegic migraine, migraine with brainstem aura, and migraine with prolonged aura because they may reduce cerebral blood flow. A European consensus panel reviewed the use of ergotamine for the acute treatment of migraine and concluded that ergotamine is the drug of choice in relatively few Many patients who have attacks with brainstem aura also report other attacks with typical aura and should be coded for both 1.2.1 Migraine with typical aura and 1.2.2 Migraine with brainstem aura. Many of the symptoms like dysarthria, vertigo, tinnitus, hypacusis, diplopia, ataxia and decreased level of consciousness may occur with anxiety and Familial hemiplegic migraine (FHM) falls within the category of migraine with aura. In migraine with aura (including FHM) the neurologic symptoms of aura are unequivocally localizable to the cerebral cortex or brain stem and include visual disturbance (most common), sensory loss (e.g., numbness or paresthesias of the face or an extremity), and dysphasia (difficulty with speech). FHM must Disease. Migraine refers to a primary headache disorder commonly characterized by severe, unilateral (alternating hemicranias), throbbing pain with associated nausea, photophobia, phonophobia, and preceding aura. Less commonly, migraines may present bilaterally, with a moderate, constant pain. [1] They are typically 4-72 hours in duration and Short version – My GF began having these migraine episodes at age 25 and was diagnosed with Migraine with brain stem aura, now a year and a half later we still have not found effective treatment and it is a constant everyday struggle for her. She has been unable to work as even moderate physical or mental exertion can trigger an episode. Migraine with aura can be diagnosed in a person presenting with at least two attacks fulfilling the following criteria: One or more typical fully reversible aura symptoms including: Visual symptoms such as zigzag lines and/or scotoma — visual aura is the most common type of aura. Sensory symptoms such as unilateral pins and needles or numbness. Migraine is a major public health problem afflicting approximately 10% of the general population and is a leading cause of disability worldwide, yet our understanding of the basis mechanisms of migraine remains incomplete. About a third of migraine patients have attacks with aura, consisting of transient neurological symptoms that precede or accompany headache, or occur without headache. For Migraine aura without headache is possible 5. Migraine with aura a. At least 1 or more fully reversible features (TYPICAL AURA: visual, sensory, speech and/or language. OTHER AURA: motor, brainstem or retinal) b. At least 3 or more characteristics: i. At least 1 aura symptom spreads gradually over ≥5 minutes (if sudden onset, think about The treatment of acute attacks of migraine with brainstem aura consists of rest, hydration and pain relief. Sumatriptan as a nasal spray and anti-emetic medications may be needed for some patients. Prophylactic treatment as above will only be necessary if the attacks are too frequent or too long and severe. tJ1M.