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What Is a Vestibular Migraine?

Vestibular migraine, or migraine-associated vertigo, is a disorder that exhibits vestibular disturbances in combination with migraine symptoms. Those with vestibular migraines do not always have a headache when symptoms occur.

Common Vestibular Migraine Symptoms

Vestibular migraine symptoms may include a combination of the following:

  • Severe one-sided, throbbing or pounding head pain
  • Nausea
  • Vomiting
  • Sensitivity to light
  • Sensitivity to sound
  • Sensitivity to motion
  • Vertigo
  • Dizziness
  • Unsteadiness

Some with vestibular migraines also experience muffled hearing, aural fullness, or tinnitus.

Vertigo or dizzy symptoms may occur before, during, or after, or totally independent of migraine symptoms. These symptoms often fluctuate with vestibular migraine triggers (Lampert et al, 2012).

How Long Do Vestibular Migraines Last?

Vestibular migraines traditionally last anywhere from 5 minutes to 72 hours (HIS, 2013).

Who Gets Vestibular Migraines?

Vestibular migraines affect about 7.8 million Americans. Age of onset is typically during teenage years to age 40, and females are more likely to suffer from vestibular migraines than males. Vestibular migraines have a strong link to family history (Lempert and Neuhauser, 2013)..

How Are Vestibular Migraines Triggered?

Vestibular migraines can be provoked by specific triggers. These may include behavioral triggers, like poor sleep, increased stress, or strenuous exercise, or chemical triggers, like chocolate, caffeine, alcohol, or MSG. Others with vestibular migraines may have environmental triggers, like changes in barometric pressure, high temperature, high humidity, while others notice worsened vestibular migraines during menstruation and menopause (Andress-Rothrock et al, 2009).

How Do Vestibular Migraines Affect Daily Life?

If left unmanaged, vestibular migraines can be debilitating to daily life and can prevent completion of daily activities, including home life, work, and school responsibilities and tasks (Neuhauser et al, 2006).

Who Diagnoses Vestibular Migraines?

Vestibular migraines can be diagnosed and managed with a multidisciplinary approach, including audiologists, neurologists, otologists, and primary-care providers. Diagnosis may come after a series of vestibular tests by an audiologist, in combination with the patient’s report of symptoms. 

Can Vestibular Migraines Be Prevented?

Vestibular migraines can be prevented by managing triggers. This may include improving sleep and reducing stressors, as well as considering a vestibular migraine elimination diet.  

How Are Vestibular Migraines Treated?

Vestibular migraines can be treated with lifestyle modifications to avoid triggers, as well as medications to take preventatively or after symptoms begin. Some may also benefit from vestibular rehabilitation therapy to target any balance concerns that may have been diagnosed during balance function testing.

Think You Have Vestibular Migraines? Find an Audiologist

If you have questions about hearing loss/balance conditions or a family member needs to see an audiologist, use the Academy’s Find an Audiologist Directory to find an audiologist near you.

Find an Audiologist link

References

Andress-Rothrock D, King W, Rothrock J. (2010) An analysis of migraine triggers in a clinic-based population. Headache 50:1366–1370.

International Headache Society (IHS). Headache Classification Committee (2013) https://ihs-headache.org/en.

Lempert T, Neuhauser H. (2009) Epidemiology of vertigo, migraine and vestibular migraine. J Neurol 256:333–338.

Lempert T, Olesen J, Furman J. (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22(4):167–72.

Neuhauser HK, Radtke A, von Brevern M, et al. (2006) Migrainous vertigo: prevalence and impact on quality of life. Neurology 67(6):1028–1033.

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