Effects of nonprescription therapies on vestibular migraine: a questionnaire-based observational study.
Level 4 - case-series / case-control
Prospective uncontrolled before-and-after study (case series design)
PubMed 38204302 · doi:10.1111/imj.16314
What was done
A prospective, uncontrolled, questionnaire-based observational study evaluated 82 patients (78% female, mean age 44 ± 14 years) diagnosed with vestibular migraine at two Sydney tertiary referral clinics between November 2019 and August 2021. Patients received lifestyle optimization advice (sleep, hydration, exercise, nutrition) and took an over-the-counter supplement containing riboflavin 200 mg, magnesium 150 mg, coenzyme Q10 75 mg, and feverfew 200 mcg daily. Symptom severity and frequency were measured at baseline and 3 months after starting treatment using the Dizziness Handicap Inventory (DHI), Vertigo Symptom Score short-form (VSS-sf), and visual analogue scales for severity (VAS-s) and frequency (VAS-f).
What was found
At 3 months, mean scores decreased across all measures: - DHI decreased by a mean of 16.8 points (95% CI, 12.8–20.9), representing a 44.1% improvement. - VSS-sf decreased by a mean of 9.3 points (95% CI, 7.1–11.5), representing a 44.9% improvement. - VAS-s decreased by a mean of 3.0 points (95% CI, 2.2–3.8), representing a 44.1% improvement. - VAS-f decreased by a mean of 2.8 points (95% CI, 2.1–3.4), representing a 38.9% improvement. On individual evaluation, 41 patients (50%) on DHI and 44 patients (53.7%) on VSS-sf showed symptom improvement; 39 (47.6%) and 36 (43.9%) reported no change, while 2 patients reported symptom worsening. The supplement was reported as well-tolerated.
Why it matters
This study provides preliminary observational evidence that combined lifestyle advice and a specific multi-ingredient nutraceutical may reduce vestibular migraine symptom burden, addressing a condition with limited non-pharmacological evidence.
Limits
The study was a single-arm, uncontrolled cohort, precluding distinction between treatment effect, placebo response, regression to the mean, or natural disease fluctuation. The combined intervention makes it impossible to isolate the effect of individual supplement components versus lifestyle changes. Follow-up was restricted to 3 months, outcomes relied entirely on self-reported questionnaires, and recruitment from tertiary clinics may limit generalizability.
Cited by
- supports Magnesium supplementation, alongside B vitamins and CoQ10, is effective in alleviating migraine symptoms and associated tinnitus or dizziness exacerbations.