Vestibular Migraine

About Vestibular Migraines

A migraine is a common problem affecting nearly 10% of the population. It is seen more in females and more commonly in the 2nd – 4th decade. A vestibular migraine is a common cause of vertigo in young and middle-aged people alike. The literature states that around 10% of the population is suffering from a migraine. A vestibular migraine occurs in 10% of migraine patients. Women are more prone to this than men which is similar to traditional migraine patterns. Vestibular migraines can also occur in children. It is a form of a migraine which affects the vestibular nerve. This disorder affects the day to day life of patients and may lead to anxiety.

Symptoms

Vestibular migraine patients usually complain of headaches before, during or after the dizzy spells. However, headaches are not seen in all the patients Sometimes, headaches occur more frequently before and the vertigo symptoms are predominant.

The chief symptom of a vestibular migraine is recurrent spells of dizziness that may last from few seconds to days.

  • Nausea and Vomiting –which may present
  • Motion sensitivity – a sensation of dizziness when one moves the body, head or eyes.
  • Unsteadiness
  • Disorientation
  • Increased sensitivity to sound or light
  • Motion sickness

Diagnosis

The following recommendationshave been proposed by the International Headache Society to help doctors diagnose Vestibular migraine:

Frequent migraine headaches – either at present or in the past. Experiencing minimum five vertigo episodes. This feeling is different from feelings of fainting or uneasiness as experienced during motion sickness. A vertigo episode lasts for few minutes to 72 hours. You experience moderate to severe symptoms that hinder your everyday activities.

At least half of the episodes happen with one of the following migraine symptoms:

  • A headache that has any of the two of these characteristics: one-sided, pulsating, moderate to severe, gets worse with activity
  • Sensitivity to light or sound
  • Seeing flashing lights before your eyes (a migraine aura) at the beginning of a vertigo spell

Treatment

Neurologists and Neuro-otologists are specialized in diagnosing and treating vestibular migraine. Patients with a vestibular migraine require lifestyle modifications like eating and sleepingon time reducing caffeine, salt and alcohol intake. For patients having more than three episodes in a month, migraine prophylasis must be started with medicines like beta blockers, calcium channel blockers, SSRI’s and antiepileptic medications. Terminating the headaches and controlling vertigo with vestibular suppressants may be necessary.