When a person with a history of migraines gets dizzy suddenly & also begins experiencing other vertigo-like symptoms, it is called a vestibular migraine. One of the most distinguishing features of a vertigo attack is the sudden sensation of the surroundings moving or spinning out of control. Our bodies balance themselves using delicate coordination of three organ systems; the eyes, the muscles of the body that help in movement, & the vestibular system. The vestibular system is the system inside the inner ear that provides balance & position-related signals to the brain so that it can process the information & give adequate signals to the movement muscles.
When even a single one of these systems don’t function properly, the body’s balance goes haywire & a person experiences vertigo, dizziness, & other balance problems. A Vestibular Migraine is different from a traditional migraine in that the patients don’t get a headache at all, but just experience balance issues, dizziness, & other vertigo symptoms.
Many people who experience basilar migraine(sharp headaches with an aura), also tend to get vestibular migraines, although that is not true for every person. Vestibular Migraines might last anywhere from a few minutes to a few hours, although in some cases, they can last for over a few days as well.
Very rarely, vestibular migraines can last for longer than 72 hours. Most people only experience vestibular migraines for up to a few minutes & a few hours. During an episode of vestibular migraine, you might experience dizziness, a feeling of being off-balance, & lightheadedness. You might also find that moving your head seems to make the symptoms worse.
The incidence of Vestibular Migraine is about 1% in the entire population. Vestibular Migraine also remains the top cause of spontaneous vertigo in people with a history of migraines. In children, these episodes are known as ‘Benign Paroxysmal Positional Vertigo’ of childhood. These children are also more likely to get migraines later in life, as compared to other children who don’t experience vestibular migraine episodes.
Vestibular Migraine Symptoms:
The primary Vestibular Migraine symptom is a spontaneous episode of vertigo. If you have a history of migraines & suddenly start experiencing dizzy spells, your doctor will likely chalk it up to vestibular migraine. In addition to spontaneous dizziness & vertigo episodes, patients might also experience symptoms including:
- A general feeling of being imbalanced
- Motion sickness, caused or worsened by moving your head
- Sudden dizziness from looking at moving objects like cars on the road or people walking & running
- Feeling lightheaded
- A feeling of being on a rocking boat or chair
- Nausea
- Vomiting
Causes of Vestibular Migraine:
The medical community isn’t yet sure as to the exact causes of vestibular migraine, although an abnormal release of chemicals in the brain could be a reason. Some other factors can also be the cause of vestibular migraines in people who already have a history of migraines. These causes & triggers include:
- Stress
- A lack of sleep
- Dehydration
- A change in the weather or the barometric pressure
- Upcoming menstrual period
Some foods & drinks have also been seen to trigger episodes of vestibular migraine in people who are predisposed to migraines. These include:
- Chocolate
- Red wine
- Cheeses that have aged
- Monosodium glutamate(MSG)
- Processed meats
- Coffee
- Sodas that have caffeine in them
There seems to be a hereditary component to vestibular migraines, as they sometimes tend to run in families. Women are also more likely than men to get vestibular migraines.
Vestibular Migraine diagnosis:
Vestibular Migraines can be difficult to diagnose, as the dizziness symptoms tend to overlap with those of a lot of other vestibular disorders. To accurately diagnose your condition as a vestibular migraine, your doctors will ask for a detailed medical history, symptom history, & follow the guidelines recommended in the International Classification of Headache Disorders.
The guidelines suggest that a person meets the criteria for a vestibular migraine diagnosis if:
- They have had at least 5 or more moderate to severe episodes of vertigo lasting from 5 minutes to 72 hours
- Have previously experienced or still get, migraines with or without aura
- Have had at least 50% of vertigo episodes that have included the following phenomena:
--painful sensitivity to light, photophobia, & sound, phonophobia,
--a visual aura
--a headache with at least two of the following characteristics:
--centered on one side of the head
--a feeling of it pulsating
--it has a moderate to severe intensity
--it worsens with any physical activity
--their dizziness symptoms can’t be explained by any other condition.
In order for your doctor to be able to give you the best treatment available, they need to rule out any other causes for your symptoms. Specifically:
- Any nerve irritation or fluid leaks in your inner ear
- Transient Ischemic Attack(TIA), also known as a ministroke
- Meniere’s Disease, which is an inner ear disorder
- Benign Paroxysmal Positional Vertigo(BPPV), a type of peripheral vertigo that causes sudden bouts of moderate to intense vertigo & dizziness symptoms
Vestibular Migraine Treatment:
Vertigo medications & dizziness medications can also be helpful in providing relief to patients of vestibular migraines. Vertigo medications help treat nausea, vomiting, motion sickness, dizziness, & a couple of other symptoms.
If your vestibular migraine episodes are pretty frequent, your doctor might prescribe the medications that are useful for other kinds of migraines to you. These include:
- Beta blockers,
- Triptans such as sumatriptan(Imitrex)
- Anti-seizure drugs like Iamotrigine(Lamictal)
- Calcium channel blockers
- CGRP antagonists like erenumab, also known as Aimovig
It is also among useful Vestibular Migraine Home Remedies, to avoid any potential food & drink triggers that might exacerbate your migraines. Try keeping a diary of all that you’ve eaten throughout the day & notice which foods/drinks tend to cause vestibular migraine symptoms. You can then use this information to help avoid any foods/drinks that trigger your vestibular migraines.
There are also some Vestibular Migraine exercises that you can try to get rid of dizziness & other vertigo-like symptoms the next time you get an episode. However, try not to move your head too much during these exercises as movement might worsen your vestibular migraine symptoms.
Some other lifestyle changes that can help with reducing the intensity & severity of your vestibular migraines include:
- Getting adequate sleep throughout the day & enough rest.
- Exercising regularly to keep yourself fit & in shape
- Drinking plenty of water & staying hydrated throughout the day
- Indulging in stress-reducing activities like gardening, meditation, knitting, dancing, singing, poetry, painting, listening to music, etc.
- For women who tend to get a vestibular migraine attack right around the time of their menstrual periods, it might help to take water pills & avoid any salty & spicy foods
Your doctor might also prescribe you some medications & exercises to help resolve your dizziness symptoms, along with other vertigo-like symptoms. It’s important to constantly keep in touch with your doctor about any new developments in your vestibular migraines so that they can check them out timely.
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