For many people, a migraine attack includes severe head pain. But not all types of migraine look or feel the same. Vestibular migraine, for example, affects your sense of balance. Often during an attack, you can feel like you’re moving, falling or spinning when you’re actually sitting still. We call this sensation vertigo. Alongside vertigo, a vestibular migraine can also include more typical migraine symptoms such as phonophobia, photophobia and often ear pain, pressure or ringing—but not necessarily headache.
What is vestibular migraine?
The vestibular system is found in the inner ear and helps control your balance. When it is not working properly, it is associated with symptoms of vertigo. The condition can come on spontaneously or can be triggered by specific factors such as moving your head, placing your head in a specific position, looking at specific patterns or moving objects.
Vestibular migraine is the second-most common cause of vertigo in adults. Vertigo can happen at any point during a migraine attack.
Noticing a consistency in time between a vertigo attack and migraine symptoms, regardless of when the vertigo occurs during the migraine attack, if they are linked, then a diagnosis of vestibular migraine could be made.
A headache isn’t always present during vestibular migraine attacks. Therefore, you should also look for other migraine-type symptoms like light sensitivity and sound sensitivity to help diagnose your condition. In addition, experiencing head fuzziness, fatigue,difficulty finding words and other symptoms such as dry mouth, sweating, diarrhoea, excessive yawning, tingling, scalp tenderness or visual blurring.
Many with vestibular migraine also report a history of motion sensitivity or motion sickness beginning in childhood.
Vestibular migraine affects up to 3% of the adult population and affects up to 5 times more women than men. Most patients have a personal history of migraine headache and/or motion sickness, as well as a family history of migraine or similar episodic vertigo or dizziness.
A typical patient with vestibular migraine is a woman in her late 30s or 40s with a history of migraine and motion sickness. While migraine may improve with age, vestibular symptoms often increase. These symptoms can affect a patient’s daily life, including their ability to drive, work and travel.
While there isn’t a cure for vestibular migraine. The help of an experienced headache practitioner, may help patients learn to manage their triggers, helping them live a normal life.
How can you lessen the impact of symptoms?
If you are affected by vestibular migraine, noticing your triggers are important. Many are very similar to migraine—food-type triggers like caffeine, chocolate or alcohol, missing meals, weather changes, not enough sleep, stress, hormone changes, bright or flashing lights.
Consider what happens before, during and after a migraine attack. How do you feel? Is there something in particular that seems to come along with your migraine symptoms?
Keeping a headache journal is a good way to identify patterns
Note specific examples of all your symptoms, such as dizzy spells or visual disturbances. Tracking your symptoms, noting possible triggers and discussing treatment options with a doctor can help prevent and relieve vestibular migraine attacks. However, not all attacks have a trigger.
Your doctor may discuss options such as Vitamin B2, magnesium and Coenzyme Q10 supplementation. Other treatments include prescription medications such as triptans as well as neuromodulation devices like the vagus nerve stimulator or external trigeminal nerve stimulator.
If you think you may have vestibular migraine, a headache specialist will be able to diagnose your condition and discuss your options for treatment and prevention.