Severe migrainous vertigo responds to steroids

August 30, 2009

Migrainous vertigo seems to respond to intravenous infusion of a high dose of corticosteroids, according to a report in the latest issue of Headache by a group of Indian doctors. Two of their patients had intermittent episodes of severe vertigo and two had chronic vertigo. All four respond to infusions of 1 gram of methylprednisolone. One require 3 infusions, one needed 2 and in another 2 vertigo stopped after a single infusion. We routinely use corticosteroids for severe migraine attacks when other medications fail. While occasional (once or twice a month) use of corticosteroids is relatively safe, frequent or daily intake of corticosteroids (besides methylprednisolone, these drugs include prednisone, prednisolone, and dexamethasone) can lead to dangerous side effects. It is possible that oral corticosteroids will produce a similar effect as an infusion and may be worth trying when nothing else helps relieve the vertigo.

Written by
Alexander Mauskop, MD
Continue reading
March 26, 2026
Alternative Therapies
Lidocaine-Based Treatments Offer Another Option for Severe Migraines
This post explains how lidocaine, beyond its traditional use as a local anesthetic, can be given by IV or directly into the middle meningeal artery to help break severe, treatment-resistant migraines, with early studies showing promising relief and generally mild, manageable side effects.
Read article
February 16, 2026
News
Potential big news for the 40 million Americans with migraine.
It is long overue to make triptans available without a prescription, like in the rest of the world.
Read article