When discussing a vestibular migraine, it’s important to understand how a migraine, differs from a headache first. A headache, by definition, is an ache in the head. Where as a migraine is a much more severe/complex condition, which may results in a headache, as well as several other symptoms, known as “auras”. A severe headache is not necessarily a migraine and a migraine does not necessarily cause an ache in the head.
Common migraine auras include:
- Visual disturbances (including blind spots, patches etc)
- Light sensitivity
- Sound sensitivity
- Nausea and vomiting
- Pins and needles or numbness
When a patient is suffering from a vestibular migraine, they will experience symptoms such as vertigo, imbalance and general dizziness, which often worsen with certain movements. It is also possible to experience neck pain and tinnitus during a vestibular migraine, along with general headaches. Current research around what actually causes vestibular migraines is still not fully understood. The common train of thought currently is that abnormal signals are sent to the brain via the source of the migraines (eg. the neck) but instead of being transmitted like a normal migraine, is transmitted to the vestibular system. Often a diagnosis of vestibular migraine is made when all other possibilities have been ruled out and the symptoms match the above list. At first, the inner ears will be tested for vertigo, followed by a full central assessment, to rule out any nasty underlying causes. In a lot of patients, their necks may be involved in their vestibular migraine and as such, this is tested. If it is determined to be playing a role, it will be treated accordingly, via manual therapy. Along with this, most patients with vestibular migraines respond well to balance retraining and general vestibular rehabilitation exercises.
Most patients who suffer from a vestibular migraine are also encouraged to seek pharmaceutical help from their Doctors, in order to desensitise their dizzy and balance symptoms. There has also been recent evidence to suggest a regular healthy lifestyle can improve vestibular migraine symptoms including:
- Regular exercise
- Avoiding food that will trigger migraines (eg. Dark chocolate, red wine etc)
- Maintaining regular fluid intake
- Consistent sleep
Vestibular migraines are a serious diagnosis. But with proper therapeutic treatment and a healthy lifestyle, it can be managed to a point where patients no longer experience any symptoms.
Author: Benjamin Sewell