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Vestibular Migraine

Vestibular Migraine

Did you know that vestibular migraine is one of the most common and debilitating causes of vestibular symptoms including dizziness, vertigo and motion sensitivity?

  • Have you ever had a migraine in your life? Did you know they often ‘disappear’ for up to decades and can re-surface as a different type of headache?
  • Do you know that there are many migraine variations that don’t even come with a headache?
  • Have you experienced a headache that is throbbing, felt on one side of the head, or associated with nausea or sensitivity to light, sound or smell? These could be migraines – many people have them without ever being diagnosed. 
  • Were you aware that dizziness triggered by rapid head movements, repeated movement or looking at flickering lights or busy patterns, or even after eating certain foods, could be a vestibular migraine?

What is Vestibular Migraine?

If dizziness and imbalance are a major part of your migraine attacks, you may be experiencing vestibular migraine. People who have had migraines for many years may also go on to develop Vestibular Migraine.

The diagnosis of Vestibular Migraine can be difficult, as vestibular migraine can be experienced at the same time as other symptoms. It can also occur alongside other vestibular disorders such as vertigo and PPPD (chronic dizziness), or it can present with the same symptoms and ‘mimic’ them. Due to the fact that symptoms come and go, and even vary between episodes in the same person, vestibular migraine can be missed or misdiagnosed, and is often called the ‘great chameleon’. The delay in diagnosis can certainly be frustrating.

Episodes of dizziness can be as short as a few minutes or as long as several days. The dizziness may feel like a sense of unsteadiness or imbalance. People who experience vertigo with vestibular migraine can feel the awful sensation of their surroundings moving or spinning, or have the sense that they are moving when they are not. Veering to one side when trying to walk is very common during episodes, and can be extremely frightening.

The events can be triggered by food, drinks or environments that trigger other types of migraine; however, rapid head movements, or looking at flickering lights or busy patterns such as checkerboards, can bring them on too. Other typical triggers include riding on an escalator, or looking for items on supermarket shelves.

Common Symptoms

  • Can occur with or without an actual headache
  • Typically, episodes of dizziness can be as short as a few minutes or go on for several days
  • Can involve combinations of the following symptoms:
    • Migraine headache symptoms, such as:
      • Moderate to severe throbbing headache, usually on one side of the head
      • Nausea and vomiting
      • Sensitivity to light, smell and noise
    • Vestibular symptoms may include:
      • Vertigo (dizziness), usually lasting minutes to hours, but sometimes days
      • Unsteadiness and loss of balance
      • Sensitivity to motion
  • Hearing symptoms (without significant hearing loss) e.g. ringing, fullness, pressure in one or both ears
  • Visual aura
  • Sensitivity to visual stimulation and motion

Possible Triggers of Vestibular Migraine

  • Stress or stress let-down
  • Lack of sleep or oversleep
  • Diet, including some types of alcohol
  • Hormonal factors in women such as the oral contraceptive pill, hormone replacement therapy and menopause
  • Bright lights
  • Intense smells
  • Motion e.g. riding on an escalator, or looking for items on supermarket shelves
  • Often there are no obvious triggers.

How can we Help?

Vestibular physiotherapists will complete a detailed assessment of your condition to confirm the diagnosis and help you to understand those things that might trigger your migraine. If there is predominantly motion-induced dizziness, our team can help you to reduce your symptoms by prescribing exercises targeted at managing your condition according to your specific needs. They will often prescribe exercises that will help you recover from an episode once it has finished. It is important that you see a physiotherapist with experience in managing people with this condition, as exercises need to be carefully prescribed and monitored to ensure you get the best possible outcome.

What Should I Expect From my Appointment?

  • Detailed Interview: This helps us to gain a full understanding of your symptoms and medical history.
  • Physical Assessment: We assess your body, head and eye movements and vestibular reflexes, using the latest technology. This enables us to accurately assess your symptoms and develop a customised treatment plan for you.
  • Targeted Treatments: Where appropriate, we use specialised treatment methods to manage your symptoms.
  • Progressive Exercise Program: We teach you specially designed exercises and movements to retrain your brain, as well as exercises to build strength, endurance, coordination and balance, in line with your exercise goals. We will also teach you how to manage your condition, how to recognise and minimise triggers and to recognise and treat the condition, should it come back.
  • Communication and Collaboration: With your General Practitioner and/ or ENT or other specialists to keep them informed of your progress and to support your care.

Where can I see my Physiotherapist?

On this page

In Clinic

Online Video Appointments

Web & Mobile App

Private Gymnasium