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Vestibular migraine: Causes, Symptoms, Treatments

Do you have a history of migraines and ever had a feeling of vertigo? Or the sense that objects are moving around in front of you? If so, you may be experiencing a vestibular migraine.

Inside our ears, we have a system that allows the body to find balance. This is referred to as the vestibular. A vestibular migraine doesn’t necessarily cause headaches or pain. Instead, you may experience vertigo, feel off-balance, dizzy, and lightheaded.

What is a vestibular migraine? 

A Man With Migraine

It’s common for those who experience a vestibular migraine to not feel pain at all. Usually, this type of migraine will last only for seconds or minutes. They rarely last hours or days, although some have reported vestibular migraines lasting for up to 72 hours.

The symptoms can be confusing and uncomfortable for the individual. Some report that moving their head can make the symptoms much worse. 

Vestibular migraines are rare. Only 1% of the population is thought to experience this type of migraine. It can also affect young children and is known as “benign paroxysmal vertigo of childhood.”

It’s believed that children who are affected with “benign paroxysmal vertigo of childhood” have an increased risk of migraine issues in the future.

What does a vestibular migraine feel like, and what are the symptoms of a vestibular migraine?

The primary symptom of a vestibular migraine is a vertigo episode. Vertigo is a sensation of whirling and loss of balance. If you’ve ever stood on top of a very tall cliff or building, you will have likely felt this sensation.

Typical symptoms of a vestibular migraine include:

  • Loss of balance
  • Motion sickness
  • Feeling lightheaded
  • Dizziness
  • Feeling disorientated
  • Vomit and nausea

Some people who suffer from vestibular migraines report feeling car sick or the sensation of being on a rocking boat. 

Is vestibular migraine a chronic illness?

Some research has suggested there are two subgroups of patients suffering from vestibular migraines. This includes chronic vestibular migraine and primary persistent vestibular migraine. 

Chronic vestibular migraine is a condition attributed to those who have been observed as suffering from vestibular migraine for 15+days per month for longer than three months. Clinical experience has shown that vestibular migraines can take a chronic course of disease.

Primary persistent vestibular migraine is attributed to those who suffer from very sudden vestibular migraines not caused by any other condition. 

What triggers a vestibular migraine?

Spiral Stairways

The medical world is not 100% sure about what triggers vestibular migraines. Many doctors believe it may be down to an abnormal release of chemicals in the brain. But, there is still lots of more research needed.

Often, what triggers a vestibular migraine is the same as what triggers regular migraines, including:

  • Poor sleep
  • Lot’s of stress
  • Dehydration
  • Menstruation
  • Weather changes
  • Changes in light exposure

It’s believed that women are at a higher risk of experiencing vestibular migraines. 

According to Healthline, the following foods and drinks can also trigger vestibular migraines:

  • chocolate
  • red wine
  • aged cheeses
  • monosodium glutamate (MSG)
  • processed meats
  • coffee
  • sodas with caffeine

How long do vestibular migraines last?

 Vestibular migraines can last anywhere from 5 minutes to 72 hours. Some patients can also suffer from persistent vestibular migraine symptoms lasting months to years with episodic exacerbations. 

These symptoms are typically accompanied by regular migraine symptoms, including headaches, photophobia, phonophobia, and other auras.

How is a diagnosis made?

Diagnosing vestibular migraines can be difficult. At the current moment, there is no specific test to take. So, it’s best to make an appointment with your local doctor to discuss your symptoms and history of migraines plus other medical issues.

From there, your doctor can start to uncover whether you, in fact, are suffering from vestibular migraines. There are also factors to be considered that are laid out in the International Classification of Headache Disorders.

  • Five vertigo episodes lasting 5 minutes to 72 hours
  • History of migraines with or without an aura
  • Half of your vertigo episodes involving one or more of the following: photophobia, phonophobia, visual aura, headache, pain on one side of the head, pulsating feeling, intensity of pain from moderate to severe, or headache worsens with movement or physical activity. 
  • Consideration of another condition with similar symptoms

You must involve your doctor when diagnosing vestibular migraines. The doctor will be able to combine all the data, observations, and current research to pin down your condition.

What is the best treatment for vestibular migraines?

Unfortunately, there is no current medication for vestibular migraines. As it is an extremely rare condition affecting 1% or less of the population, much research is still needed to identify a useful medication.

Instead, if diagnosed with vestibular migraine, you will likely be prescribed medication commonly used for severe migraine conditions. You will probably be given medication for isolated symptoms like dizziness, motion sickness, vomiting, and nausea. 

Your doctor may prescribe you with a variety of drugs that help fight the vestibular migraines when they happen. This is also known as abortive therapy and is likely to include:

  • Triptans - to be taken at the first sign of migraines symptoms
  • Vestibular suppressant - this will relive any dizziness and nausea.
  • Conventional migraine meds - will usually relieve symptoms of regular migraines such as motion pain, pulsating, and nausea.

As well as medications, your doctor may also prescribe a migraine device such as The Migraine Stopper. This neuromodulation device is an innovative patented ear pump operated by the migraine patient. It works by using gentle and precise positive and negative air pressure to stimulate two nerves in the ear for the goal of migraine relief.

It is designed to stimulate the trigeminal nerve and vagus nerve to calm down the over-excited brain stem. 

Living with vestibular migraine

Man and Headache

There are lots of great ways to help deal with vestibular migraines. Discovering your triggers is a long game of trial and error. It’s best to keep a notepad and write down when symptoms occur and start to detail everything you did around this time. 

You may start to draw links between certain foods, light, places, sounds, or habits triggering your conditions. Here are some tips for living with vestibular migraines.

Dietary Choices

Many people that suffer from migraines and vestibular migraines report that certain foods can trigger symptoms. The most common include:

  • Foods high in salt and sugar
  • Foods and drinks containing caffeine, alcohol, and nicotine
  • Not drinking enough water

After the symptoms of your migraine have subsided, try to note everything you ate and drink before proceeding the episode. Eliminate any apparent triggers listed above for at least a week. Keep a diary and keep track of any improvements.

The process of elimination is long and sometimes difficult but can be very beneficial in the long run.

Lighting

Fluorescent lights are a common trigger for those with migraine conditions. Avoid this type of light as much as possible.

Be aware that in public buildings such as restaurants or stores, they control the lights with a rheostat, which can be visually disorientating.

Avoid flashing imagery such as in films, in theme parks, or at live events.

Travel

Travel can be tough for those with vestibular migraine. If flying, the frequent altitude and pressure changes can be distressful and trigger symptoms. 

Specific motion patterns and disruptive lighting on public transport can also be problematic. This makes travel very difficult for people with vestibular migraines.

To help, avoid flying at all costs unless absolutely necessary. If you can choose the train or car, then they will be more comfortable for you. 

When traveling, try to avoid using laptops, phones, or kindles. Keep your head high and look out onto the horizon as much as possible.

Wear a pair of sunglasses and/or hats to help protect your eyes from overexposure or flickering of sunlight.

Managing Fatigue

Keeping your energy level high with vestibular migraines is no easy feat. To help, evaluate what type of activity is most important to your life. What is absolutely necessary and what can wait?

Don’t be afraid to ask others for help if the activity may be too much for you. Learning to accept what you can and can’t do is essential in coping with fatigue. 

Finally, adequate sleep, lots of water, a healthy diet, and physical wellbeing are essential factors in coping with fatigue. Your mental wellbeing is also vital. Make time to practice some mindfulness techniques such as meditation or light stretching.

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