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    Could your Dizziness be due to Migraine?

    Could your Dizziness be due to Migraine?

    Dr. Anita Bhandari | Neurotologist | Last Updated: 24th Nov, 2023

    Migraine is a one of the commonest causes of headache. But did you know that migraine is also one of the commonest causes of dizziness?

    The National Headache Foundation reported a 70% rise in the number of migraine attacks after the pandemic. Migraine is commonly thought to be just a headache. But it actually can present in many ways like imbalance, dizziness, disorientation, neck pain, or the common throbbing headache.

    Over 10% of migraine sufferers have vertigo and dizziness as their main symptom. This form of migraine is called Vestibular migraine. It is usually associated with nausea and vomiting or difficulty in concentrating.

    The dizzy episodes can last from seconds to hours to days. While migraine attacks often involve recurrent, throbbing headaches, vestibular migraine may or may not have any accompanying headache. Many Vestibular migraine patients cannot tolerate loud sounds or bright lights. This is called sensory amplification, meaning that their sensory systems are over sensitive. These patients often have motion sickness. Vestibular migraine is more common in patients in the 20–40-year age bracket but children as young as 5 years and seniors up to 60 years may suffer from it as well.

    Common migraine triggers

    Most vestibular migraine patients will have certain triggers which bring on their attacks. The most common triggers include inadequate sleep, skipping meals, stress, and extended screen time (this was increased multi-fold during the pandemic!)

    How do we diagnose Vestibular Migraine?

    A thorough history is the most important part of the workup of these patients. This should be followed by a Vestibular evaluation which involves assessment of the balance system by various tests like VNG (Videonystagmography), Subjective Visual Vertical (SVV), Dynamic Visual Acuity (DVA), etc. NeuroEquilibrium is the world’s largest chain of Vertigo and Balance Clinics in with over 170 centres in India. These clinics are equipped to diagnose and treat all causes of vertigo and dizziness.

    How is Vestibular Migraine treated?

    Vestibular migraine is largely influenced by diet and lifestyle. Some simple dietary tips to reduce the incidence and severity of dizzy episodes are-

    • Eating on time – skipping breakfast is the singularly most important trigger to increase your headaches and imbalance. Taking out those 15 minutes in the morning to have breakfast is the first and most important part of your treatment. Fasting can also aggravate symptoms.
    • Reduce your caffeine intake – slow down on your tea, coffee and chocolates!
    • MSG – monosodium glutamate is used as a taste enhancer used especially in Chinese food. Avoid MSG intake.
    • Alcohol – certain types of alcohol particularly red wine have been seen to trigger migraine attacks.

    Some lifestyle modifications which help in controlling the headaches and dizziness in migraine include:

    • Reducing screen time – long hours in front of your phone or laptop can cause a lot of strain and aggravate migraine. Try not to look at the screen when you are scrolling.
    • Try to relax and cool down mentally. Many migraineurs are highly driven perfectionists. This strains the already overworked nervous system. “Letting go” will actually go a long way in helping you get better. Also read Don’t Panic If You Have A Vertigo Attack! Instead, Follow This
    • Try to sleep on time. Adequate sleep has deep healing properties on the nervous system.

    Besides lifestyle and dietary modifications, many patients of vestibular migraine require treatment called “Migraine prophylaxis” to bring the problem under control. Your doctor will decide which medication would be most suitable for you. Migraine prophylaxis is decided according to the severity of symptoms, gender, weight and associated co-morbidities of the patient. The treatment typically lasts for several months but the medicines may change according to the response to treatment. That is why regular follow-up is important.

    Many vestibular migraine patients also require counselling in the form of Cognitive Behavioural Therapy (CBT).

    It’s important to remember that Vertigo and dizziness are treatable! Don’t let dizziness shake your confidence. A Vestibular evaluation to assess your balance system will be the guide to the diagnose and plan the best treatment for your problem.

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