June 2026 Newsletter Highlights

Research Update in Concussion

A recent study in the Journal of International Advanced Otology found that nearly 13% of patients presenting to the emergency department with a mild traumatic brain injury had benign paroxysmal positional vertigo (BPPV), highlighting that post-concussion dizziness is not always solely attributable to concussion symptoms. Female patients and those with higher-energy mechanisms of injury were at greater risk of developing post-

traumatic BPPV. These findings reinforce the importance of early vestibular screening and positional testing following concussion, as BPPV is a common and highly treatable cause of dizziness that may otherwise delay recovery.

Dao JCML, Van der Geest I, Makineli S, Emmink BL, Bruintjes TD, Schermer TR, Winters SM. Benign Paroxysmal Positional Vertigo in Patients with Mild Traumatic Brain Injury: A Multidisciplinary Study. J Int Adv Otol. 2026 Jun 8;22(2):1-7. doi: 10.65717/iao.2026.252084. PMID: 42345429.

Research Update in Migraine

A recent review examining CGRP-targeting therapies for vestibular migraine found promising early evidence that medications such as erenumab, fremanezumab, and galcanezumab may reduce vertigo frequency, dizziness-related disability, and monthly

migraine days in patients who have not responded to traditional preventive treatments. Across four observational studies involving approximately 100 patients, improvements in vestibular symptoms were consistently reported with few significant side effects. However, the authors emphasize that no randomized controlled trials currently exist, highlighting the need for higher-quality research before these therapies can be routinely recommended for vestibular migraine management.

Ciubotaru A, Mastaleru A, Schreiner TG, Grosu C, Alexa D, Oancea A, Vamanu A,

Roceanu AM, Cucu AI, Pana BI, Cozma RS, Olariu R, Dan Iulian C, Ignat EB. CGRP-

Targeting Therapies in Vestibular Migraine: A Synthesis of Observational Evidence

with Direction-of-Effect Analysis. Med Sci (Basel). 2026 Jun 4;14(2):288. doi:

10.3390/medsci14020288. PMID: 42346827.

Sports Medicine Provider Spotlight

Sports medicine providers play an important role in the management of athletes and active individuals with dizziness, concussion, migraine, and exercise intolerance. Early collaboration between sports medicine, rehabilitation providers, and other specialists can improve diagnostic accuracy, streamline return-to-play decisions, and ensure that

underlying contributors such as vestibular dysfunction, autonomic dysregulation, or cervical impairments are addressed alongside symptom management. By working together and maintaining open communication throughout recovery, we can provide more comprehensive care and help patients return to sport, work, and life activities safely and confidently.