Efficacy of Low-Dose BoNT-A Acupoint Injections in Managing Headache, Vertigo, and Allodynia in Vestibular Migraine

BACKGROUND: This study examines low-dose botulinum toxin at acupuncture points for its effects on vestibular symptoms, headaches, depression, anxiety, and stress in vestibular migraine patients.

METHODS: This prospective study included patients with vestibular migraine per Barany Society criteria. Fifty units of Onabotulinum toxin were injected using a 31-gauge needle at 5 units/0.1 mL, diluted from 100 units with 2 mL of 0.9% sodium chloride. The injections were given at predetermined acupuncture points: Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20), and Tianzhu (BL10). Six-month follow-up assessments included assessments using the Migraine Disability Assessment Scale (MIDAS), Dizziness Handicap Inventory-Screening Form (DHI-S), Vertigo Symptom Scale-Short Form (VSS-SF), Depression Anxiety Stress Scale (DASS-21), and Allodynia Symptom Checklist (ASC-12).

RESULTS: Statistically significant improvements were observed in MIDAS, VSS-SF, DHI-S, and DASS-21 scores at both 3 and 6 months (P < .05).

CONCLUSION: Application of Onabotulinum toxin A (BoNT-A) to acupuncture points alleviated headache, vestibular symptoms, and anxiety, with benefits persisting for up to 6 months.

Cite this article as: Aydemir G, Ardıç FN, Kara CO, Değirmenci E. Efficacy of low-dose BoNT-A acupoint injections in managing headache, vertigo, and allodynia in vestibular migraine. J Int Adv Otol. 2025, 21(4), 1876, doi: 10.5152/iao.2025.251876.