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Vestibular migraine

Vestibular migraine or migrainous vertigo is a type of migraine that may or may not cause a headache, but can include a number of debilitating symptoms affecting the ears, vision and balance. It is the second most common cause of vertigo.

What do the symptoms of vestibular migraine feel like?

Alongside symptoms of vertigo, imbalance and dizziness, during a vestibular migraine some sufferers may also find head movement involved in turning, bending down or looking up intolerable, feel a pressure within their head and/or ear, have neck pain, find it hard to hear low sounds, or develop tinnitus (a ringing or other sound in the ear). People may also experience headaches, visual disturbances such as hazy or blurred vision, sparkles or blotches in their vision, or loss of part of their vision.

What causes vestibular migraine?

The cause of vestibular migraine is not completely understood. However, it is thought that it is caused by abnormal ‘electric’ messages, which lead to a widening of the blood vessels in and around the brain, including the vestibular artery in the inner ear’s balance control system.

How is a diagnosis made?

If referred to a specialist by your GP, a diagnosis of your condition will be made based on your medical history, answers to questions about when and where the symptoms occur, and a physical examination.

How is vestibular migraine treated?

Treatment of vestibular migraine can include:

  • preventative medications if the regularity and severity of symptoms are interfering with your life
  • medication to relieve symptoms
  • making lifestyle changes to remove the symptom triggers, such as alcohol, not enough sleep, or stress.

Preventative medications may be prescribed and these need to be taken every day whether or not you feel unwell. Migraine episode treatments may also be prescribed, including pain relief medication and anti-nausea medication. Vestibular rehabilitation/physiotherapy has been shown to be effective if symptoms of movement-provoked dizziness, or imbalance, persists between episodes of migraine. For more information about vestibular physiotherapy, including how to access a vestibular physiotherapy service, please click here.

Living with vestibular migraine

For almost all patients, the combination of a healthy lifestyle and medication (if necessary) will lead to a good recovery from migraines and resumption of normal activities. Lifestyle changes that reduce or prevent migraines in some people include:

  • regular exercise
  • avoiding the food and drink that triggers migraine (such as caffeine or alcohol)
  • maintaining an adequate fluid intake
  • consistent sleep patterns.

Online resources

The Vestibular Disorders Association is a US-based, patient support group. Their website contains useful information about how to understand, live with and find support for balance disorders. Visit www.vestibular.org

Definition of vestibular migraine medical terms

Vestibular system: a part of the inner ear that sends information about the position of the head to the balance control centre in the brain. See How does the balance system work? for more information.

Migraine: a chronic, generally periodic, neurological disorder, which may involve headaches and a number of associated and temporarily disabling symptoms.

Vertigo: a false sensation that you or your surroundings are moving.

Tinnitus: a subjective sound in the ear (such as ringing, buzzing, hissing or rumbling) that is not associated with any external sound.