flunarizine and Nausea

Flunarizine, 20 mg by slow intravenous injection, was studied in the acute treatment of migraine attacks in a multicentre, double-blind, placebo-controlled study. At the end of the 60 min observation period, 23 of the 31 (74.2%) patients treated with flunarizine reported complete relief, or a pain reduction of more than 50%, vs. 8 of 29 (27.6%) placebo patients (p less than 0.017). Accompanying symptoms also improved significantly better in the flunarizine than in the placebo group. The investigators evaluated the therapy as good or excellent in 77.4% of the flunarizine and in 27.6% of the placebo patients, respectively. Tolerance of the therapy was good and comparable in the two groups. Somnolence was the only flunarizine-related adverse reaction. Blood pressure and heart rate were not affected. Flunarizine i.v. deserves further study in the acute treatment of a migraine attack.

Topics: Adult; Blood Pressure; Double-Blind Method; Female; Flunarizine; Humans; Injections, Intravenous; Male; Middle Aged; Migraine Disorders; Nausea; Placebos

Vestibular symptoms frequently occur in patients with migraine headache. The common migraine is defined in neurology as a unilateral, pulsating headache, which may be associated with nausea and vomiting, and lasts one or several days. In the classic form patients have visual prodromal symptoms. Focal neurological signs in the migraine complique include, for example, oculomotor palsy and vestibular abnormalities. This so-called vestibular migraine is different from basilar migraine, which involves the irritation of the cervical sympathetic system, and can cause symptoms that resemble transient brainstem ischemia. In order to evaluate vestibular dysfunction electronystagmography (ENG) was used. Patients frequently had abnormal caloric test responses, especially with a directional preponderance, and most had a spontaneous nystagmus. In the migraine attack the patients are presumed to have hypersensitivity of the labyrinth with nausea and vomiting, while in the headache-free period the ENG was almost normal. At present, we have had a high success rate in treating patients with pyracetam. Diazepam was used to treat basilar migraine and flunarizine to prevent vestibular migraine.

Topics: Adolescent; Adult; Aged; Basilar Artery; Calcium Channel Blockers; Caloric Tests; Child; Diazepam; Ear, Inner; Electronystagmography; Female; Flunarizine; Hearing Loss, Sensorineural; Humans; Ischemic Attack, Transient; Male; Middle Aged; Migraine Disorders; Muscle Relaxants, Central; Nausea; Neuroprotective Agents; Nystagmus, Pathologic; Ophthalmoplegia; Piracetam; Sympathetic Nervous System; Vestibular Diseases; Vomiting