From the Guidelines
Inner ear seizures, also known as vestibular seizures, should be treated with anti-epileptic medications and lifestyle modifications to reduce vertigo severity and frequency, and improve quality of life. The treatment approach for inner ear seizures is similar to that of Ménière's disease, which is a clinical condition characterized by spontaneous vertigo attacks, low- to midfrequency sensorineural hearing loss, and fluctuating aural symptoms 1. The goals of treatment are to prevent or reduce vertigo severity and frequency, relieve or prevent hearing loss, tinnitus, and aural fullness, and improve quality of life 1.
Some key points to consider in the treatment of inner ear seizures include:
- Modifications of lifestyle factors, such as diet, to reduce symptoms 1
- Medical therapies, such as anti-epileptic medications, to control seizures and reduce vertigo 1
- Surgical or combination therapies may be considered in some cases 1
- Keeping a diary of episodes to track frequency, duration, and potential triggers can help inform treatment decisions [based on general medical knowledge]
It's essential to consult a neurologist for proper diagnosis and treatment of inner ear seizures, as they can be difficult to distinguish from other inner ear disorders [based on general medical knowledge]. Treatment should be individualized and based on the specific needs and circumstances of each patient 1.
From the Research
Inner Ear Seizure
- Inner ear disorders can cause a range of symptoms, including vertigo, disequilibrium, and imbalance 2, 3, 4
- Vestibular migraine is a common cause of recurrent vertigo, and its diagnosis relies solely on clinical symptoms since clinical tests of vestibular function are typically normal 3, 5
- Idiopathic labyrinthitis is an inner ear disorder characterized by sudden hearing loss and concurrent vertigo, with a poor prognosis for both hearing and balance function impairment 4
Treatment Options
- Treatment for vestibular migraine includes abortive and preventative interventions, such as migraine-specific medications, vestibular rehabilitation, and medications used for migraine prevention 2, 5
- Neuromodulation devices and medications that target calcitonin gene-related peptide (CGRP) may also be effective in treating vestibular migraine 6
- There is a need for more research and randomly controlled trials to fully understand the effects of CGRP and to establish effective treatment regimens for vestibular migraine 5, 6
Clinical Characteristics and Prognosis
- Patients with idiopathic labyrinthitis often experience persistent balance problems and activity avoidance behavior, with a poor prognosis for hearing recovery 4
- Vestibular migraine can have a significant impact on healthcare cost and utilization, and its diagnosis and treatment can be challenging due to its relatively broad spectrum of manifestations and the absence of typical migraine headaches with vestibular symptoms 3, 5