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Vestibular Migraines Explained

Medically Reviewed by Poonam Sachdev on November 12, 2021

If you have migraines, then you often have symptoms like a severe headache and throbbing pain. A vestibular migraine is a condition of the nervous system that causes dizziness or vertigo in those who have a history of migraines.

Vestibular Migraine Symptoms

“Vestibular” refers to the inner ear, which is linked to hearing and balance. When you have a vestibular migraine, you may have these symptoms:

  • Dizziness or vertigo
  • Balance problems
  • Nausea or vomiting
  • Sweating and flushing
  • Diarrhea
  • Visual blurring or flashing lights 
  • Feeling uncomfortable around bright lights or loud noises
  • Difficulty focusing
  • Extreme tiredness and fatigue
  • Sleepiness

Vestibular Migraine Triggers

Patients usually have one or more of these triggers for a vestibular migraine:

  • Stress and anxiety
  • Not sleeping well
  • Missing meals
  • Not drinking enough water
  • Dietary triggers like caffeine or certain foods
  • Hormonal changes
  • External triggers like light, weather change, smoking, etc.

Vestibular Migraine Management

Current research suggests that the best way to manage vestibular migraine symptoms is through a combination of medications, vestibular rehabilitation, and lifestyle changes.

1. Medications

A recent study has shown that preventive medication such as flunarizine can effectively treat vertigo in patients with vestibular migraines. Here are some types of medications used to manage vestibular migraines: 

  • Antiemetic medications such as dimenhydrinate and benzodiazepines
  • Anti-vertigo medicine
  • Analgesics such as triptans
  • Preventive medicine like propranolol, topiramate, valproic acid, lamotrigine, and flunarizine

2. Vestibular Rehabilitation

This is a type of exercise therapy to treat dizziness and balance problems. It helps patients get habituated and adapt to the condition.

3. Lifestyle Changes

The exact causes of vestibular migraines remain unclear. While some patients feel better with medication, research has shown that regulating lifestyle and diet helped 80% to 90% of patients. Identifying your triggers can help you prevent vestibular migraines.

Here are some dietary triggers to watch out for: 

WebMD Feature

Sources

SOURCES:

Annals of Indian Academy of Neurology: “The Treatment of Vestibular Migraine: A Narrative Review.”

Cephalalgia: “Vestibular migraine: An update on current understanding and future directions.”

Meniere's Society: “What is Vestibular Migraine?”

VEDA: “Vestibular Migraine.”

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