What is Vestibular Migraine?
Vestibular migraines can create dizzy spells that seem like they are spinning, floating, swaying, or that they are internally moving. The majority of the time, they happen on their own, but stress, sleep issues, skipping meals, dehydration, and other conditions can cause them. An episode of vertigo in someone with a history of migraines is referred to as a vestibular migraine. People who experience vertigo believe that they or the items around them are moving when they are not. The system in your inner ear that regulates your body’s balance is referred to as “vestibular.”
Contrary to other types of migraines, which are sometimes accompanied by excruciating headaches, vestibular migraines frequently entail no headache at all. Not everyone who experiences vestibular migraines also suffers from classic or basilar migraines (with auras).
Vestibular migraines might last for days even if they only last a few seconds or minutes. They rarely last for more than 72 hours. Symptoms typically last anywhere from a few minutes to many hours. You can have vertigo as well as balance issues, lightheadedness, and dizziness. You could make the symptoms worse by moving your head.
Approximately 1% of people in the population get a vestibular migraine. It is the most frequent reason for unprovoked vertigo attacks. Similar to vestibular migraines, episodes in children are also possible. It is referred to as “benign paroxysmal vertigo of childhood” in children. Later-life migraine attacks are more likely to affect those kids than other kids.
Vestibular Migraine Symptoms
The main symptom of a vestibular migraine is an episode of vertigo. Usually it happens spontaneously. You may also experience symptoms including:
- feeling imbalanced
- motion sickness caused by moving your head
- dizziness from looking at moving objects such as cars or people walking
- lightheadedness
- feeling like you’re rocking on a boat
- nausea and vomiting as a result of the other symptoms
Causes and Triggers of Vestibular Migraines
Although doctors are unsure of the exact cause of vestibular migraines, some think that abnormal brain chemical release may be a factor.
A vestibular migraine may be brought on by some of the same variables that cause other types of migraines, such as:
- stress
- lack of sleep
- dehydration
- weather changes, or changes in barometric pressure
- menstruation
Certain foods and drinks are also one of the most common trigger of vestibular migraine:
- chocolate
- red wine
- aged cheeses
- monosodium glutamate (MSG)
- processed meats
- coffee
- sodas with caffeine
Vestibular migraines are more likely to affect women. Although research has not yet conclusively shown it, doctors believe that vestibular migraines run in families.
How Vestibular Migraine is Diagnosed
The lack of a specific test makes diagnosing vestibular migraines challenging. Instead, your physician will speak with you about your symptoms and medical background while taking into account the following principles from the International Classification of Headache Disorders:
- Have you experienced between five and seventy-two hours of moderate or severe vertigo?
- Do you currently or in the past experience migraines with or without an aura?
- At least one of the following was also present in at least 50% of the vertigo episodes:a. painful sensitivity to light, known as photophobia, or to sound, known as phonophobia
b. a visual aura
c. a headache involving at least two of these characteristics:i. It’s centered on one side of your head.
ii. It feels like it’s pulsating.
iii. The intensity is moderate or severe.
iv. The headache worsens with routine physical activity. - Is there another condition that better explains your symptoms?
Your doctor will want to rule out these additional disorders that could be causing the symptoms in order to treat you as effectively as possible:
- nerve irritation or fluid leaks in your inner ear
- transient ischemic attacks (TIAs), also called ministrokes
- Meniere’s disease (an inner ear disorder)
- Benign positional vertigo (BPV), which causes brief periods of mild or intense dizziness
Treatment, Prevention and Management
The same medications that are used to treat vertigo can also be utilized to treat vestibular migraine attacks. These medicines are used to treat symptoms such as dizziness, motion sickness, nausea, and vomiting.
The same medications that are used to treat other types of migraines may be prescribed by your doctor if you frequently encounter bouts. These medicines include:
- beta blockers
- triptans such as sumatriptan (Imitrex)
- anti-seizure drugs, such as lamotrigine (Lamictal)
- calcium channel blockers
- CGRP antagonists, such as erenumab (Aimovig)
By avoiding the foods and beverages that may cause migraines, you can lower your risk of experiencing one. Keep track of your meals; you could spot a pattern. You can find out what bothers your body and triggers an episode by keeping a food diary.
A change in lifestyle can also be helpful:
- Make sure you’re getting enough sleep and rest.
- Exercise regularly.
- Drink plenty of water.
- Take up stress-reducing activities like meditation and gardening.
- If menstruation is a cause of your migraines, it may help to take a water pill and avoid eating salty foods.
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For migraines, there is no treatment. In a 2012 German study, participants with vestibular migraines were followed for over ten years. The researchers discovered that the frequency of vertigo decreased with time in 56% of cases, rose in 29% of cases, and remained stable in 16% of instances.
People who get vestibular migraines are also more susceptible to motion sickness and ischemic strokes. Discuss these disorders’ treatment and prevention with your doctor, as well as any additional worries you might have.
