Health Info > Headaches Published on : December 2, 2024

Vestibular migraine: causes, symptoms & what to do?

Written by Dr Gosagan Gopalakrishnan, BSc (Hons), MBChB, DRCOG, MRCGP, FRACGP

Vestibular migraine is a type of migraine that involves dizziness, vertigo, and balance issues, affecting the vestibular system, which controls our balance and spatial orientation. Unlike typical migraines, the primary symptoms here revolve around dizziness and spatial disorientation rather than the usual headache pain, making it a challenging condition to identify and manage. It is thought that this type of migraine is actually the second most common cause of vertigo. This article will explore the main causes, symptoms, and treatment options, providing guidance on when to consult a doctor and how Hola Health’s telehealth services can help.

What is the main cause of vestibular migraines?

The exact cause of vestibular migraine remains unclear, but it appears to be linked to abnormal interactions between the brain’s visual, balance, and pain pathways. Triggers are often similar to those of typical migraines, including stress, lack of sleep, certain foods (such as aged cheese, chocolate, and red wine), dehydration, hormonal fluctuations, and sensory overload from lights, sounds, or smells. For some, a combination of these triggers increases the likelihood of a vestibular migraine episode.

Vestibular migraine symptoms

Vestibular migraine symptoms vary, but the most common signs include:

Dizziness or light-headedness
Vertigo (a sensation of spinning or moving when still)
Imbalance or a feeling of being unsteady
Nausea and sometimes vomiting
Sensitivity to light and sound

These symptoms may occur with or without head pain, distinguishing vestibular migraine from typical migraine presentations. They can last from minutes to days, and the frequency can vary widely among individuals.

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What are the stages of a vestibular migraine?

Vestibular migraine often has four distinct stages:

Prodrome: This is the warning stage that may occur up to two days before the migraine. Symptoms can include mood changes, fatigue, neck stiffness, and food cravings.
Aura: In vestibular migraines, the aura phase may involve dizziness, light sensitivity, and visual disturbances rather than the classic zigzag lines or blind spots associated with other migraines.
Attack: This is the main phase, where dizziness, vertigo, nausea, and balance issues are most intense. It may last for hours or even days.
Postdrome: After the attack, many people feel drained, fatigued, and slightly disoriented, a period known as the “migraine hangover.”

Who gets vestibular migraines?

Vestibular migraine can affect anyone, but it is more common in women and people who have a family history of migraines. It is particularly common in individuals aged 20-50 and may affect those who already experience other types of migraines. People with anxiety disorders also seem to have a higher risk, as the anxiety-vestibular migraine connection can create a vicious circle, with anxiety heightening migraine symptoms and vice versa.

Diagnosis

Diagnosis of vestibular migraine can be challenging because the symptoms overlap with other balance disorders, such as Meniere’s disease or benign paroxysmal positional vertigo (BPPV). A doctor will likely:

Take a detailed history of symptoms and triggers.
Conduct physical examinations and balance assessments.
Rule out other causes through imaging (like MRI or CT scans) if necessary. A diagnosis often requires confirmation that the patient experiences repeated episodes of dizziness and vertigo alongside migraine symptoms and that other medical causes have been excluded.

Also read: Waking Up With A Headache: 7 Expert Tips

What is the difference between vestibular migraine and vertigo?

While both vestibular migraines and vertigo involve sensations of spinning or dizziness, the terms describe different things. Vertigo is a symptom - a sensation of abnormal motion or spinning - that a patient experiences, rather than a condition itself. It can stem from various causes, including inner ear disorders like benign paroxysmal positional vertigo (BPPV), where dislodged calcium crystals in the ear canal trigger dizziness. In vestibular migraine, however, the sensation of vertigo is due to changes in brain function rather than an issue within the inner ear.

Is vestibular migraine a neurological disorder?

Yes, vestibular migraine is classified as a neurological disorder. It affects the brain's pathways involved in balance, coordination, and spatial orientation. Like other migraine types, it involves complex neurochemical interactions that can disrupt normal sensory processing.

When to consult a doctor?

It’s essential to consult a doctor if you experience:

Frequent dizziness or balance problems without an apparent cause
Episodes of vertigo, especially if they disrupt daily life
Symptoms of migraines, including sensitivity to light, nausea, and visual disturbances, combined with dizziness If these symptoms interfere with your work, family life, or social activities, seeking medical advice is crucial to rule out other potential causes and develop a tailored treatment plan.

Can telehealth help?

Yes, telehealth offers a convenient and efficient way to manage vestibular migraines. Through Hola Health’s telehealth appointments, you can speak with a doctor who can assess your symptoms, discuss potential triggers, and recommend lifestyle changes or medications to help manage the condition. Hola’s telehealth doctors can also provide referrals to specialists or arrange for further tests if necessary, allowing you to take the next steps from the comfort of your home.

How can Hola’s online doctor help with vestibular migraines?

Hola Health’s online doctors are here to support your vestibular migraine journey, offering comprehensive care through telehealth services. With Hola’s online consultations, you have access to:

Instant consult online: Connect with a doctor at your convenience, discuss symptoms, and receive treatment recommendations without visiting a clinic.
Doctor’s referrals: If specialist care or diagnostic tests are needed, Hola’s doctors can provide referrals and guide you through the next steps.
Online scripts: Receive prescriptions electronically, making it easier to start treatment promptly.
Medical certificates: If vestibular migraine episodes impact your work or studies, Hola’s online doctor service can issue medical certificates to help manage these requirements.

Vestibular migraine can be a difficult condition to navigate, but with the support of Hola Health’s online doctors, you don’t have to face it alone. From instant consultations to expert advice, Hola Health is here to help you manage symptoms and regain control over your health. Book an online consult today to take the first step toward managing vestibular migraines effectively.

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