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 vestibular migraines than men which similar to traditional migraine patterns. Vestibular migraines can also occur in children. A vestibular migraine 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. (for more info)
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. (read more)
Increased sensitivity to sound or light
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
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.
Author: Dr. Anita Bhandari
Dr.Anita Bhandari is MS(ENT) and a consultant Neurotologist practicing in Jaipur, India. She has done a fellowship in Otology and Neurotology from Singapore. She has set up a state-of-art Vertigo and Ear Clinic in Jaipur (www.vertigoandearclinic.com) which is amongst the most advanced vertigo clinics in India.
Dr. Bhandari is actively involved in development of diagnostic equipment in the field of diagnosis and rehabilitation of vertigo and balance disorders. She has contributed to the development of Computerized Dynamic Visual Acuity , Cranio-Coprpography , Subjective Visual Vertical , Video Nystagmography and
Posturography diagnostic equipment and has two patents in this field . She has also been involved in development of Virtual reality for vestibular rehabilitation . She is Scientific advisor to NeuroEquilibrium, a unique project to set up 500 super-specialized vertigo and dizziness clinics in India , Asia & Africa leveraging cloud technology.
She has authored chapters on ‘Vestibular Physiology’, ‘Dynamic Visual Acuity’, ‘Surgical treatment of vertigo’, ‘Difficult cases in vertigo’ in various Neurotology textbooks. She is an invited speaker in various Vertigo & Neurotology conferences across the world.