Vestibular migraine


What is vestibular migraine?

Migraine can occur in a number of different forms. "Classical" migraine consists of a headache, usually on one side of the head, with a feeling of sickness (nausea), and often some visual disturbance and a sensitivity to bright lights or loud sounds.

With vestibular migraine, sometimes called migrainous vertigo, the main feature is some form of dizziness or imbalance.

The symptoms of vestibular migraine can be similar to those of Meniere's disease, and it can sometimes be difficult to tell the two apart.

What causes vestibular migraine?

We don't fully understand the exact cause of migraine, but believe it is related to changes in blood flow to the brain.

We do know that many people have specific things that may trigger their migraines. Sometimes there may be a trigger in the diet - chocolate, caffeine, cheese, red wine, yeast extract or MSG (the flavouring found in many ready-meals or packet sauces) are the common ones, although many other foods are possible triggers. Many people find that their migraines are triggered by stress or tiredness, or by missing a meal. Sometimes hormonal changes can be triggers, and many women find that their migraines are related to their monthly cycle.

There may also be a history of "classical" migraine earlier in life or of close relatives who have suffered from migraine.

What are the symptoms of vestibular migraine?

Vestibular migraine causes episodes of spinning dizziness (rotatory vertigo) or imbalance lasting between a few minutes and several hours. There are usually other symptoms to suggest migraine that come on at the same time as the dizziness. These include some form of visual problem such as distortion, wavy lines or partial loss of vision, or sensitivity to bright lights or loud sounds. Headache may or may not be a major feature, and sometimes the headache comes on after rather than during the attack of dizziness.

How can vestibular migraine be treated?

For some people, identifying and avoiding triggers in the diet may be all that is required. Sometimes these may be obvious, but if not it can be very helpful to keep a detailed symptom diary, making careful note of everything you have eaten and drunk in the 24 hours before an attack. This can show up patterns suggesting possible food or other triggers that may not have occured to you otherwise.

For some people the attacks are rare enough that just treating each attack when it happens may be the best option. If the attacks are more frequent and are significantly interfering with your life however, it may be worth considering regular medication (prophylaxis) to try and stop the attacks from happening.

We will be happy to discuss which is likely to be the best approach for you.