Journal of Neurology

, Volume 266, Issue 2, pp 525–529 | Cite as

Prophylactic treatment of migraine with and without aura with acetyl-dl-leucine: a case series

  • Michael StruppEmail author
  • Otmar Bayer
  • Katharina Feil
  • Andreas Straube
Letter to the Editors

Dear Sirs,

The prophylactic treatment of migraine is still challenging, not only because of the effectiveness of drugs given but also because of their side effects which result in a low therapy adherence [4]. Therefore, there is still a need for new, well-tolerated, and effective drugs.

In animal studies, it was shown that the modified amino acid acetyl-dl-leucine (already approved for the treatment of vertigo in 1957) normalizes neuronal membrane potential [7]. Since spreading depression and fluctuations of membrane potential are discussed as one of the crucial mechanisms of migraine [3], we hypothesized that this acetyl-dl-leucine may be effective for the prophylactic treatment of migraine. Therefore, we evaluated its effects on the frequency of attacks of migraine with and without aura.

In a prospective observational case series, ten patients (six females, age range 18–70 years, Table 1) were treated on an individual basis with acetyl-dl-leucine during a period from 01/2017 to...



We thank Katie Göttlinger for copy editing this manuscript. This work was supported by the German Ministry of Education and Research (BMBF), Grant no. 01EO0901 to the German Center for Vertigo and Balance Disorders (IFBLMU).

Author contributions

MS: conception of the study, acquisition and interpretation of the data, drafting the manuscript. OB: statistical analysis, interpretation of the data, and revising the manuscript for content. KF: conception of the study and recruitment of patients. AS: acquisition and interpretation of the data, as well as drafting the manuscript.

Compliance with ethical standards

Conflicts of interest

M. Strupp is Joint Chief Editor of the Journal of Neurology, Editor in Chief of Frontiers of Neuro-otology and Section Editor of F1000. He has received speaker’s honoraria from Abbott, Actelion, Auris Medical, Bayer, Biogen, Eisai, Grünenthal, GSK, Henning Pharma, Interacoustics, Merck, MSD, Otometrics, Pierre-Fabre, TEVA, and UCB. He is a shareholder of IntraBio. He acts as a consultant for Abbott, Actelion, AurisMedical, Heel, IntraBio and Sensorion. O. Bayer and K. Feil report no relevant conflicts of interest/financial disclosures. A. Straube has received speaker’s honoraria from Allergan, Novartis, TEVA and Recordati. He received honoraria for adboard participation from Allergan, Novartis, TEVA, Eli Lilly, electroCore.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

All patients gave their informed consent for the compassionate use of acetyl-dl-leucine.


  1. 1.
    Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 33:629–808CrossRefGoogle Scholar
  2. 2.
    Bremova T, Malinova V, Amraoui Y, Mengel E, Reinke J, Kolnikova M, Strupp M (2015) Acetyl-dl-leucine in Niemann-Pick type C: a case series. Neurology 85:1368–1375CrossRefGoogle Scholar
  3. 3.
    Brennan KC, Pietrobon D (2018) A systems neuroscience approach to migraine. Neuron 97:1004–1021CrossRefGoogle Scholar
  4. 4.
    Hepp Z, Dodick DW, Varon SF, Gillard P, Hansen RN, Devine EB (2015) Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia 35:478–488CrossRefGoogle Scholar
  5. 5.
    Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, Bisdorff A, Versino M, Evers S, Newman-Toker D (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22:167–172Google Scholar
  6. 6.
    Strupp M, Teufel J, Habs M, Feuerecker R, Muth C, van de Warrenburg B, Klopstock T, Feil K (2013) Effects of acetyl-dl-leucine in patients with cerebellar ataxia: a case series. J Neurol 260:2556–2561CrossRefGoogle Scholar
  7. 7.
    Vibert N, Vidal PP (2001) In vitro effects of acetyl-dl-leucine (tanganil) on central vestibular neurons and vestibulo-ocular networks of the guinea-pig. Eur J Neurosci 13:735–748CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyLudwig Maximilians University, MunichMunichGermany
  2. 2.Reliatec GmbHGarchingGermany
  3. 3.Ludwig Maximilians University, MunichMunichGermany

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