Individual vestibular migraine attacks are usually only treated if they are acute and long-lasting. Treatment often involves the same kinds of medications used to treat acute vertigo attacks: anti-vertiginous drugs (eg, promethazine), anti-nausea drugs (eg, metoclopramide, dimenhydrinate, or benzodiazepines), and/or antihistamines. Unfortunately, there is currently a lack of clinical trial data regarding the specific treatment of vestibular migraine. For example, it is not known whether conventional treatments for other types of migraine such as triptans, NSAIDs, and ergots are effective and safe for treating vestibular migraine.3 This is an important area for future research.

Due to this lack of data and because vestibular symptoms are often relatively brief, non-pharmaceutical approaches for treating and preventing vestibular migraine attacks are often recommended by physicians. The first important step is for the patient to receive the correct diagnosis and to understand how migraine can cause these vestibular symptoms, in order to lessen anxiety and fear during attacks. As suggested for managing other types of migraines, patients should keep a diary to record the details of symptoms and attacks. Identifying and avoiding potential triggers, such as disrupted sleeping and eating patterns, is also recommended.