When Migraine Makes you Dizzy
- Olivia Orr
- 48 minutes ago
- 3 min read
Written by Olivia Orr, RN BSN
Dizziness? Nausea? A ringing sound in your ear? Light sensitivity? Vestibular migraine is often the culprit. You don't have to have a headache to experience a migraine attack, and many people with vestibular migraine do not have headache. Dizziness is their biggest enemy.
What is Vestibular Migraine?
Vestibular migraine (VM) is a migraine subtype characterized by dizziness, vertigo, light and sound sensitivity, tinnitus (ear ringing), ear pressure, and sometimes a headache. A headache doesn't have to exist to be diagnosed as migraine. Dizziness is the most reported symptom, persisting from 5 minutes to 72 hours. Typical migraine symptoms may also appear, such as
confusion
word-finding difficulty
yawning
sweating
tingling
irritability
GI symptoms (diarrhea, nausea, vomiting)
fatigue.
Vestibular migraine is not well understood. It is more common in women, with many having a history of motion sickness. Multiple theories try to explain it. One belief is that the blood vessels in the inner ear tighten during a migraine attack, reducing blood flow. Other possibilities are structural abnormalities, trigeminovascular system activation, familial genes, and head trauma. Science will eventually learn the exact reason, but for now, we know how to manage the symptoms.
Treatment
Medications, such as NSAIDs, beta blockers, calcium channel blockers, and some antiepileptics, can reduce VM symptoms, but their effectiveness and adverse reactions vary person to person. Commonly recommended supplements are magnesium, coQ10, and riboflavin (vitamin B2). In some cases, botulinum toxin and external neuromodulation devices can be helpful. Vestibular rehabilitation has been reported to improve balance and vertigo.
Be aware of the available treatment options and discuss with your doctor which one may be the best option for you to try first. For many migraineurs, a unique combination works well. Be your own advocate and change what's not working until it does work. Daily habits such as sleep quality, nutrition, and exercise also play an important role in managing symptoms. To reduce migraine frequency, learn and track what triggers your migraine episodes.
Triggers
A migraine trigger is anything that causes a migraine attack. Vestibular migraine triggers are similar to triggers in other types of migraine:
Stress
Weather changes
Food (chocolate, alcohol, msg, etc.)
Dehydration
Skipping meals
Lack of sleep
Hormonal shifts
Certain lighting (screens, fluorescent, flickering)
Specific patterns
Certain head movement
After each migraine episode, write down what you think may have triggered the attack. Over time, you will recognize a pattern of what occurs before a migraine attack. Avoid those triggers and add new triggers to the list as needed (you may have multiple). There are apps available to download that help track triggers and identify trends.
The threshold theory for migraine says the more you're exposed to a trigger, especially multiple triggers, the more likely you are to have an attack. For example, if you go to bed late, oversleep, and then skip breakfast because you're late for work, you may be at higher risk of a migraine attack. Keeping your trigger threshold low is a technique to reduce the frequency of migraine episodes.
When to Seek Care/Diagnosis
If you suspect vestibular migraine, schedule an appointment with your primary care physician. Contact your doctor or local emergency department if you experience new vertigo, vertigo with a severe headache, weakness, slurred speech, one-sided weakness or numbness, or prolonged symptoms after an injury. Your primary care physician may refer you to a neurologist, a headache specialist, or an ENT for further evaluation.
Final Thoughts
Vestibular migraine is disorienting and unpredictable, especially in the beginning. While severe migraine can be disabling, there are many treatments and prevention options available once VM is recognized. Understanding migraine and how to manage it is the first step toward relief and stability. With time and experience, your migraine may be more of a manageable disruption than a life-altering diagnosis.
References
Assessed and Endorsed by the MedReport Medical Review Board
