10 Vestibular Migraine Questions Answered

  • By Dizzy & Vertigo Institute
  • June 30, 2020
If you’ve been getting migraines for years and are now starting to get frequent dizzy spells too, then you may have vestibular migraine. And if you’ve never heard of vestibular migraine, then you’re not alone. Although vestibular migraine (VM) is the second most common balance disorder, many people are unfamiliar with the term. Your doctor might also call it Migraine-Associated Vertigo, Migrainous Vertigo, or Migraine-Related Vestibulopathy. Nonetheless, you have questions and we have answers:

Why Is It Called Vestibular Migraine?

Just based on the name, you’d guess that Vestibular Migraine was a combination of dizziness and headaches. But this is misleading. It’s actually just a variety of migraine that affects the vestibular system and causes imbalance symptoms. It’s counter-intuitive, but headaches and migraines are not always a symptom of vestibular migraine.

How Common is VM?

Vestibular migraines are still relatively unknown to the general population even though an estimated 1% of people will get VM in their lifetime.

What Does A Vestibular Migraine Feel Like?

Many describe a vestibular migraine episode as having their senses overwhelmed and then their balance swept out from under them. Some of the common symptoms of VM are:
  • Issues with balance: feeling like your balance is off or wobbly
  • Dizziness when the head is moved: a sense of spinning or dizziness during head motion. Can occur with or without nausea.
  • Internal Vertigo: the false sensation that your body is rotating, twirling, swaying, or wobbling
  • External Vertigo: the false sensation that the world around you is spinning or flowing
  • Hypersensitive to physical movement: especially intolerant to movement of the head and neck. Changing head position brings on feelings of dizziness.
  • Hypersensitive to visual movement: highly sensitive to viewing something move, possibly coming down with a sense of seasickness after witnessing movement
  • Motion sickness: higher likelihood of experiencing motion sickness
  • Nausea and/or vomiting: migraine-induced nausea and vomiting are associated with migraine-related vertigo
  • Ear pressure: a fullness feeling in ears

How Long Do VM Symptoms Last?

There’s a lot of variation in the duration of a VM episode:
  • Episodes lasting minutes: 30% of patients
  • Episodes lasting hours: 30% of patients
  • Attacks lasting several days: 30% of patients
  • Approximately 10% have attacks lasting seconds only. These tend to occur repeatedly during head motion, visual stimulation, or after changes of head position.
It’s also quite common to have an “aftershock” period where symptoms are felt to a lesser degree for weeks following an episode. Because VM can be a lingering condition, it’s important to find ways to cope with one’s symptoms. Here are some Tips for Living with Vestibular Migraine.

What Causes Vestibular Migraine?

Unfortunately, doctors aren’t entirely sure. Like migraines, there are many theories. But how it really happens isn’t understood. Most credit VM to misfires between nerve cells in your brain.

What Triggers A Vestibular Migraine Episode?

Weather, certain foods, stress, an increase in fatigue. These are common triggers. But episodes also spontaneously happen for no apparent reason.

Do I have Migrainous Vertigo?

While it’s not a condition you can self-diagnose, if you have a history of migraines and are now beginning to get vertigo-like symptoms, then you might have VM. First, contact a neurologist or neuro-otologist who specializes in migraines. They’re a great first step in discussing your symptoms. Additionally, Vestibular Audiologists (like the Dizzy & Vertigo Institute) are a great resource. We run a variety of tests to rule out possible disorders that can mimic vestibular migraine. More info on these tests here. Before you visit a specialist, come prepared with careful notes of your symptoms. When it started, what type of movement it is, whether you spin, sway or rock, if you get lightheaded or nauseous, what makes your symptoms better or worse. These are all helpful in coming to a diagnosis.

Is Vestibular Migraine Dangerous?

The actual symptoms themselves aren’t dangerous. However, there’s always the chance that a dizzy spell occurs at an inopportune moment. For instance, in the middle of driving. Combatting this danger is really about knowing your condition, taking note of when your attacks occur, what causes them, etc… Knowing your triggers can help you avoid bad situations from happening.

How is VM Treated?

Treating vestibular migraine consists of a combination of dietary changes, supplements, exercise, VRT (vestibular rehabilitation therapy), CBT (cognitive behavioral therapy), and medications. This article provides an in-depth description of each type of treatment.

How Effective is VM Treatment?

Like so many vestibular disorders, you should find solace in knowing that most people find a way to live a normal life again. Treatment lessens (or eliminates) the symptoms and patients learn how to cope with the lingering effects.

What should I do now?

If you or someone you know experiences VM or thinks they do, then give us a call at (310) 954-2207 or schedule an appointment here. We can help you get the resources and treatment you need.
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