| Popis: |
Vestibular migraine (VM) is a chronic disorder in which migraine creates vestibular symptoms (1). The International Headache Society (IHS) and the Bárány Society have defined VM as repeated vertigo episodes in migraine patients as a new vestibular central entity (2,3). The cause of VM is still unknown, and all proposed mechanisms are based on migraine's presumed pathophysiology (4). While migraine affects 13 - 16 % of the adult population in Croatia and worldwide (5,6), VM is the most common neurologic cause of vertigo (1,7), with a prevalence ranging from 0.89 to 2.7 % in the adult population (2,7–9). Despite its significant impact on healthcare utilization and quality of life (6), VM is still underdiagnosed (7). Many studies have found a decrease in quality of life in patients with vertigo (9–13), but only two clinical studies used the SF-36 questionnaire to measure a reduction in quality of life in patients with VM (14,15). The pharmacological treatment of VM includes treatments to relieve the symptoms of specific episodes as well as preventative treatments to reduce the frequency and severity of these episodes (16). In 2015, a Cochrane review of prophylactic treatments discovered that seventy different drugs could potentially be used for this purpose (17). The majority of pharmacological agents recommended for VM prophylaxis are derived from the therapeutic arsenal of migraine headaches (18). Several drugs, including beta-blockers (propranolol), antiepileptics (topiramate), calcium channel antagonists (flunarizine), and antidepressants (amitriptyline), have high-quality evidence for migraine headache prevention. As a result, these agents are almost unanimously recommended as first-line drugs for VM prevention by American, Canadian, and European guidelines (2,18,19). Radtke et al. re-evaluated patients with VM after a mean of 9 years. They noted only 36 % of those who were aware of their diagnosis and informed about treatment options had tried migraine prophylaxis. They concluded that only 13 % of those polled were still taking preventive medication (20). Our goal is to determine the quantity of VM patients in south Croatia with acute VM attacks that do not use the prescribed prophylactic therapy for VM, and why they give up using that therapy. Finally, we will assess their quality of life using the SF-36 questionnaire. |
