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Vestibular Migraine- Causes, Triggers, Diagnosis, and Treatment

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Vestibular migraine occurs with or without headaches and can cause balance or vestibular symptoms. Read below to learn more.

Written by

Dr. Shikha

Medically reviewed by

Dr. Prakashkumar P Bhatt

Published At October 14, 2022
Reviewed AtFebruary 27, 2024

What Is a Vestibular Migraine?

Migraine is a prevalent neurological disorder that affects many people. Although most migraines are characterized by a throbbing or pounding headache, vestibular migraines can include or exclude headaches with symptoms such as vertigo, imbalance, nausea, and vomiting. A vestibular migraine is a neural system disorder that produces dizziness or vertigo on a regular basis in patients who have previously had migraine symptoms. They may not constantly have a headache, unlike classic migraines.

Vestibular migraines might last a few seconds or minutes, but they can also continue for several days. They rarely last more than 72 hours. You may feel off-balance, dizzy, and light-headed, in addition to vertigo. It is possible that moving the head will exacerbate such symptoms. A vestibular migraine affects roughly one percent of the population. It is the most prevalent cause of vertigo episodes that occur without warning. Children may also have bouts that resemble vestibular migraines. It is known as benign paroxysmal vertigo of childhood, which is present in youngsters. Later in life, those children are more likely than others to suffer from migraines.

What Causes and Triggers Vestibular Migraine?

Vestibular migraines, like other migraine diseases, have a family history. Although the complicated processes of migraine have yet to be fully understood, it is known that women are more sensitive to the disorder compared to men and that symptoms may worsen around menstruation. Additionally, migraine triggers such as:

  • Disrupted sleep patterns.

  • Items such as monosodium glutamate or MSG.

  • Menstrual cycle.

  • Food such as chocolate, ripened or matured cheese, red wine, processed meats, soda with caffeine, and coffee.

  • Sleep deprivation.

  • Stress.

  • Dehydration.

  • Weather changes.

What Are the Symptoms of Vestibular Migraine?

Vertigo is the most common symptom observed in vestibular migraine. It usually happens on its own. One may also experience the following symptoms:

  • Motion sickness is induced by moving your head.

  • Feeling unbalanced.

  • Dizziness from looking at moving vehicles such as cars or people walking.

  • Nausea and vomiting.

  • Lightheadedness.

  • Headache that is severe and throbbing, usually across one side of the head.

  • Light, smell, and noise sensitivity.

Vestibular migraine can cause a person to have a combination of vestibular episodes, sensitivity to visual stimuli or visual aura and motion at various times, and it can happen with or without a headache.

How to Diagnose Vestibular Migraine?

As there is no clear-cut test for vestibular migraines, they can be challenging to identify. Instead, the doctor will talk to the patient about their symptoms and medical history, as well as factors outlined in the International Classification of Headache Disorders:

1. The doctor will check if the patient experienced at least five episodes of moderate or severe vertigo that lasted from five minutes to 72 hours.

2. If the patient experiences migraines with or without an aura, and if so, how often the patient gets them?

3. At least one of the following was also present in at least half of the vertigo episodes:

  • Photophobia (painful sensitivity to light) or phonophobia (painful sensitivity to sound.)
  • Presence of a visual aura.
  • Experiencing headache with at least two of the following symptoms:

a)It is centered on one side of your head.

b) It has a pulsing sensation.

c)It has moderate or severe intensity.

d)Regular physical exercise aggravates headaches.

4. The patient will be asked if there is anything else that could possibly be causing the symptoms.

The doctor will probably schedule an MRI to examine the patient’s brain, as well as hearing and balance tests to rule out any ear issues.

Meniere's Disease: It is a condition that affects the inner ear. One of the ears normally feels full, congested, or hurts before the patient gets dizzy. One or both ears may ring, or the patient may lose hearing during an incident. This is unusual in the case of vestibular migraine.

Stroke of the Brainstem: In which the patient also experiences numbness, weakness, difficulty speaking, and other stroke symptoms in addition to vertigo.

In order to provide the patient with the best treatment possible, the doctor will want to exclude the following illnesses that could be causing the symptoms:

  • Transient ischemic attacks (TIAs) are often known as ministrokes.

  • Benign positional vertigo (BPV) is a condition that causes mild to severe dizziness for brief periods of time.

  • Fluid leaks in the inner ear (an inner ear disorder).

  • Irritated nerves.

What Is the Treatment for Vestibular Migraine?

Vestibular migraine is treated in the same way as other migraine headaches. If the patient has frequent attacks, the doctor may prescribe one or more of the following drugs, as well as others:

  • Beta-blocker.

  • Tricyclic antidepressants.

  • Calcium channel blockers.

  • Topiramate.

  • Serotonin or Norepinephrine.

  • Anti-seizure medications.

It is possible to find relief through the usage of certain technologies such as:

  • Cefaly is a little headband gadget that stimulates a nerve connected to headaches by sending electrical pulses through the forehead.

  • The gammaCore is a non-invasive vagus nerve stimulator that, when put over the vagus nerve in the neck, stimulates the nerve fibers with a moderate electrical current to reduce discomfort.

  • SpringTMS or eNeura sTMS is a gadget that emits a magnetic pulse that stimulates the area of the brain and can be held at the back of the head during the first sign of a headache.

Maintaining a regular sleep and diet schedule, exercising frequently, avoiding triggers, and managing stress can help people with vestibular migraines lessen the number and severity of their attacks.

Conclusion:

Migraines have no known remedy. Knowing what causes the headaches can help one avoid migraine-related vertigo. Some people are sensitive to chocolate, cheese, alcohol, and foods containing the preservative MSG. These things may also trigger the symptoms if the patient is suffering from vestibular migraines. It is not a bad idea to eliminate them from the diet and see if the symptoms improve. Vestibular migraine sufferers are more prone to experience motion nausea and are at a higher risk of ischemic strokes. Discuss the treatment and prevention of such problems, as well as any other concerns the patients may have, with the doctor.

Dr. Prakashkumar P Bhatt
Dr. Prakashkumar P Bhatt

Neurology

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vestibular migrainevestibular disturbance
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