Vestibular Migraine

Vestibular migraines are common and are tricky to diagnose as they may or may not involve headaches. Vestibular migraines may include symptoms such as vertigo, imbalance, motion sensitivity, and nausea. Symptoms may last for minutes, hours, or even days and be mild or severe. The symptoms can be frightening as they may mimic other inner ear disorders or more serious conditions such as a stroke.

What causes a vestibular migraine?

Vestibular migraines, like other migraine syndromes, tend to run in families. Vestibular migraine triggers are often similar to migraine headache triggers such as stress, barometric pressure changes, diet, or hormone fluctuations.

Vestibular migraines can involve combinations of the following symptoms:

Migraine Headache Symptoms Such As...

  • Severe, throbbing headache, usually on one side of the head
  • Nausea and vomiting
  • Sensitivity to light, smell, and noise

Vestibular Symptoms Such As...

  • Vertigo (dizziness), usually lasting minutes to hours, but sometimes days
  • Unsteadiness and loss of balance
  • Motion sensitivity
  • Tinnitus such as ringing or static in the ear/s or head
  • Pressure in ear/s or head
  • Neck stiffness

Visual Symptoms Such As...

  • Visual aura (blind spots, dots, loss of parts of vision)
  • Sensitivity to visual motion
  • Sensitivity to bright lights and colours

How is a Vestibular Migraine Diagnosed?

Because many people who have vestibular migraines do not have vestibular symptoms and headaches occurring at the same time, the diagnosis is often difficult and sometimes overlooked. It is also common for vestibular migraine, Méniére’s disease and BPPV to coexist, which can make diagnosis more challenging.

Audio-vestibular testing is important in helping to identify the possibility of a vestibular migraine.

What is the treatment for a Vestibular Migraine:

Vestibular migraine management may involve lifestyle measures such as changes to diet, sleep, exercise, or stress. It may also involve supplements or prescription medications. It is important to discuss common medical management with your family physician, neurologist, or ENT. Following medical management, vestibular rehabilitation may also be required.