In the differential diagnosis of dizziness as a primary symptom, consider migraine.
So says Peter Behan, MB, ChB, consulting neurologist at the University of Glasgow, Scotland, who has seen 32 patients in three years whose primary symptom was recurrent vertigo of such severity as to send them to bed.
The diagnosis was confirmed in these patients when all responded to antimigraine medication, Behan told an international migraine symposium, which was part of the World Neurology Congress held in Kyoto, Japan. The mean age of the patients was 30 years, with a range from 8 to 65 years.
Thirty of the patients had at least a 50% reduction in their attacks when treated with 1 mg of pizotyline three times per day. In the other two patients, propranolol hydrochloride was effective. All patients were followed up for up to three years.
Behan told JAMA MEDICAL NEWS that the new agent pizotyline