In this episode, we’re going to cover some common questions about advocating for treatments at the doctor’s office, which can occur for a few different reasons. Having research to help advocate for your needs not only helps you educate future people, it also helps provide objective evidence for your specific needs. Areas we’re gonna talk about are: CGRPs, why tryptans are often less effective for the dizziness side of VM, benefits of Botox, benefits of Timolol eye drops, and VM masquerading as BPPV. We’re also talking about the triad of VM, hypermobility, MCAS, and POTS. And then BPPV, MDDS, and PPPD. Save this episode! You’re going to want to listen to it more than once because there is so much good stuff in here. In this episode, we’ll dig into: Why having research helps you advocate for your specific needs at the doctor CGRPs for vestibular migraine Why tryptans are often less effective for the dizziness part of a VM attack What the research says about Botox for vestibular migraine What studies show about Timolol eye drops Why vestibular migraine is commonly misdiagnosed as BPPV Why VM, hypermobility, POTS, dysautonomia, and MCAS so often appear together What to ask about if you keep getting recurrent BPPV A 2024 MdDS treatment protocol that had a 64% improvement rate How a sleep apnea assessment helps both VM and BPPV patients Knowledge is one of the most powerful tools you have when it comes to advocating for your care—and now you have a little more of it. Related Episodes: What is Optimal Bloodwork?: https://thevertigodoctor.com/podcast/98-optimal-vs-normal-bloodwork/ How to Get a Dizziness Diagnosis: https://thevertigodoctor.com/podcast/154-how-to-get-a-dizziness-diagnosis-with-a-bonus-resource-guide/ Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Guide with links from the episode in this Canva doc: https://www.canva.com/design/DAHQDflgIhM/TiRFvtDhQ9AY2hPv2SkBRA/edit Free Resources: The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n The PPPD Management Masterclass: https://thevertigodoctor.myflodesk.com/new-pppd What your Partner Should Know About Living with Dizziness: https://thevertigodoctor.myflodesk.com/partnership The FREE Mini VGFit Workout: https://thevertigodoctor.myflodesk.com/minifit The FREE POTS – safe Workouts: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com Otherwise, I’ll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Love what you heard? Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Citations Russo, C. V., Saccà, F., Braca, S., Sansone, M., Miele, A., Stornaiuolo, A., & De Simone, R. (2023). Anti-calcitonin gene-related peptide monoclonal antibodies for the treatment of vestibular migraine: A prospective observational cohort study. Cephalalgia : an international journal of headache, 43(4), 3331024231161809. Hoskin, J. L., & Fife, T. D. (2022). New Anti-CGRP Medications in the Treatment of Vestibular Migraine. Frontiers in neurology, 12, 799002. https://doi.org/10.3389/fneur.2021.799002 Staab JP, Eggers SDZ, Jen JC, et al. Rizatriptan vs Placebo for Attacks of Vestibular Migraine: A Randomized Clinical Trial. JAMA Neurol. 2025;82(7):676–686. doi:10.1001/jamaneurol.2025.1006 Oh, S. Y., Kang, J. J., Kim, S., Lee, J. M., Kim, J. S., & Dieterich, M. (2022). A preliminary trial of botulinum toxin type A in patients with vestibular migraine: A longitudinal fMRI study. Frontiers in neurology, 13, 955158. https://doi.org/10.3389/fneur.2022.955158 Migliazzo, C. V., & Hagan, J. C., 3rd (2014). Beta blocker eye drops for treatment of acute migraine. Missouri medicine, 111(4), 283–288. Cossack M, Nabrinsky E, Turner H, Abraham A, Gratton S. Timolol Eyedrops in the Treatment of Acute Migraine Attacks: A Randomized Crossover Study. JAMA Neurol. 2018;75(8):1024–1025. doi:10.1001/jamaneurol.2018.0970 Hac, N. E. F., & Gold, D. R. (2024). Advances in diagnosis and treatment of vestibular migraine and the vestibular disorders it mimics. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 21(4), e00381. https://doi.org/10.1016/j.neurot.2024.e00381 Blitshteyn S. (2023). Dysautonomia, Hypermobility Spectrum Disorders and Mast Cell Activation Syndrome as Migraine Comorbidities. Current neurology and neuroscience reports, 23(11), 769–776. https://doi.org/10.1007/s11910-023-01307-w Libonati, G. A., Leone, A., Martellucci, S., Gallo, A., Albera, R., Lucisano, S., Bavazzano, M., Chiarella, G., Viola, P., Galletti, F., Freni, F., Ciodaro, F., Marcelli, V., Tortoriello, G., di Santillo, L. S., Picciotti, P. M., Galli, J., Vitale, S., Quaranta, N., Cavallaro, G., … Graziano, G. (2022). Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants. Audiology research, 12(4), 445–456. https://doi.org/10.3390/audiolres12040045 Schoenmaekers C, Jillings S, De Laet C, Zarowski A and Wuyts FL (2024) Guideline for standardized approach in the treatment of the Mal de Debarquement syndrome. Front. Neurol. 15:1359116. doi: 10.3389/fneur.2024.1359116 Beh, S. C., Chiang, H. S., & Sanderson, C. (2021). The Interconnections of Mal de Débarquement Syndrome and Vestibular Migraine. The Laryngoscope, 131(5), E1653–E1661. https://doi.org/10.1002/lary.29214 Xue, H., Wang, B., Meng, T., Zhao, S., Wang, Q., Zhang, X., Kang, M., & Xiang, W. (2021). Differences of Sleep Disorders Between Vestibular Migraine and Benign Paroxysmal Positional Vertigo. Frontiers in psychiatry, 12, 726038. https://doi.org/10.3389/fpsyt.2021.726038 treatment for vestibular migraine, botox for vestibular migraine, living with vestibular migraine, VM, CGRP medications, CGRPs for migraine, BPPV, PPPD, chronic dizziness, vestibular group fit, VGF, migraine management
