Vestibular migraine targets the nervous system and causes repeated dizziness and vertigo for patients with a medical history of migraine symptoms. The word vestibular refers to the balance systems of the body, often associated with the inner ear. A vestibular migraine is also called migrainous vertigo, migraine-associated vertigo and migraine-related vestibulopathy.
If migraine or vertigo run in your family, you are more likely to suffer from vestibular migraine. In some cases, those with a vestibular migraine diagnosis might not suffer from regular headaches, as symptoms can vary.
What makes vestibular migraine different?
During a migraine attack, patients often experience vertigo. Vertigo is a feeling of moving or spinning while the person sits still. It often feels like the world moves around you. Vertigo can be triggered by outside factors like specific head positions, moving your head or looking at triggering patterns and objects. In other cases, it might spontaneously occur despite the lack of triggers.
A vestibular migraine results in sensations of significant external or internal vertigo. Due to the addition of such specific symptoms, vestibular migraine has its own category in the International Classification of Headache Disorders (ICHD).
While vestibular migraine only affects a small portion of the adult population, this condition occurs more often in women. If you have a family history of migraine and motion sickness, you are likelier to experience vestibular migraine.
While there is no cure for vestibular migraine, patients can learn to manage triggers through exercise, medication, devices and healthy living habits.
Symptoms of vestibular migraine
A vestibular migraine may cause issues stemming from the inner ear, which often controls hearing and balance. From extreme headaches and sensitivity to light to intense vertigo resulting in motion sensitivity and loss of balance, vestibular migraine can be debilitating. Those with vestibular migraine may experience several symptoms or a combination of a few. Vestibular migraine symptoms may include:
- Headaches: Throbbing or severe headaches may occur on one side of the head.
- Nausea: Severe headaches may cause nausea and vomiting.
- Sensitivity: You might be sensitive to smells, noises or light.
- Vertigo: Vestibular symptoms may include vertigo and dizziness, which could last minutes, hours or days.
- Imbalance: Vestibular symptoms may also include loss of balance.
- Motion sensitivity: You might experience sickness or dizziness when moving your body, eyes or head.
- Disorientation: You might become confused or disoriented when experiencing headache and vestibular symptoms.
Causes and diagnosis
The causes of vestibular migraine are relatively unknown, though scientists have discovered that the condition runs in families and affects more women than men. Many women find that their symptoms worsen during menstruation. While vestibular migraine often affects older adults, children and younger adults also experience the condition.
Diagnosing vestibular migraine may require a certain set of criteria. See a doctor and explain your specific symptoms before attempting to self-diagnose. The International Headache Society and other organizations have set specific criteria to help doctors diagnose you.
For example, you might have vestibular migraine if you have:
- Family history of vestibular migraines: Many with vestibular migraine have family members who have experienced the same symptoms. You might also have personally experienced such signs in the past.
- Five or more vertigo episodes: You must have experienced five vertigo episodes.
- Long-lasting or severe symptoms: Your symptoms must last between five minutes and 72 hours. Your symptoms must range between moderate to severe.
- Migraine symptoms: You must experience migraine symptoms, such as extreme pain, loss of vision, nausea or dizziness.
According to the organizations, you must experience the following symptoms during half of your episodes to be diagnosed with vestibular migraine:
- Headaches: Your headaches must be one-sided, severe or pulsing.
- Sensitivity: Your symptoms must include light and sound sensitivity.
- Aura: Aura includes flashing or shimmering lights in your vision.
Related conditions
Those with vestibular migraine might also experience Ménière’s disease, benign paroxysmal positional vertigo (BPPV) and transient ischemic attacks (TIA).
Ménière’s inner ear disease is linked to migraine symptoms like vertigo. While many patients experience symptoms in one ear, it may spread to both. Symptoms may include vertigo, tinnitus, hearing loss and ear pressure. Many with Ménière’s disease can experience vestibular migraine.
Sudden head movements can trigger benign paroxysmal positional vertigo (BPPV) and may cause dizziness or spinning sensations. Many with a vestibular migraine may also have BPPV.
Transient ischemic attack (TIA), also called a mini-stroke, may result from an interrupted blood supply to the eye or brain. It often happens before a stroke and presents similar symptoms to a migraine with aura. If you present any migraine or stroke symptoms, see a doctor immediately.
Treatments for vestibular migraine
While there is no cure, vestibular migraine treatments help patients manage symptoms and improve daily life. Some available treatments for vestibular migraine include beta-blockers, tricyclic antidepressants, calcium channel blockers, serotonin or serotonin and norepinephrine reuptake inhibitors (SSRIs or SNRIs) or topiramate.
Your doctor might also work with you to reduce episodes through healthy living habits. For example, you might exercise and practice a regular sleeping and eating schedule. You can also avoid known triggers, such as:
- Stress
- Seasonal allergies
- Dehydration
- Excessive sun exposure
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