Vestibular migraine 

• Vestibular migraine is a type of migraine causing vertigo, dizziness, and imbalance
• Vestibular migraine symptoms can be quite disabling and can leave you feeling drained
• Treatment for vestibular migraine exists and focuses on prevention

Vestibular migraine is a common type of migraine which can cause debilitating symptoms. These symptoms of vestibular migraine often include dizziness, vertigo, and imbalance. Other common symptoms of migraine can be present as well. Recognizing the symptoms of this condition and identifying your triggers can help you take preventative measures to relieve your symptoms. In this guide by Ada’s medical team, you’ll find more information about vestibular migraine, as well as its causes, diagnosis, and treatment options. 

Vestibular migraine is quite a common condition affecting about 40% of people suffering from migraine. Vestibular migraine is a subtype of a migraine, which is characterized by a sensation of vertigo, dizziness, or imbalance. Vestibular migraine occurs more often in women, especially during their twenties, thirties and forties. 1

The symptoms of vestibular migraine are similar to those of a regular migraine, with the exception that people suffering from vestibular migraine will experience issues with their balance and will suffer from vertigo. This can be perceived as a sensation of dizziness or a feeling as if the room is spinning. Besides this, regular migraine symptoms can occur such as: 2

• Headache
• Visual changes or aura 
• Tiredness
• Sensitivity to light, sound, smells, touch or motion
• Nausea
• Vomiting

Other possible vestibular migraine symptoms are: 2

• Feeling pins and needles or numbness in the face
• Tinnitus, hearing loss, or a feeling of fullness in the ear
• Sweating or feelings of panic 
• Feeling fuzzy or dizzy

Important to note is that not all episodes of vestibular migraine cause a headache, making it more difficult to recognize this condition.

Vestibular migraine causes are not fully understood yet. Scientists believe that vestibular migraine might be caused by temporary changes that occur to the nerves and the blood flow to the brain. People who have a relative suffering from vestibular migraine, or people who have already experienced migraines themselves are more likely to experience vestibular migraine as well. 2

Although the causes of vestibular migraine are still uncertain, there are some vestibular migraine triggers which have been identified. Knowing these triggers is important, as it can help you understand why vestibular migraine occurs, and it can help you manage your symptoms by avoiding these triggers. Some known triggers of vestibular migraine are: 2

• Stress
• Hormonal changes
• Bright lights
• Flashing lights
• Loud noises
• Dehydration
• Changes to the weather
• Low blood sugar
• Allergies
• Certain food
• Drinking caffeine or alcohol
• Certain medications
• Screen use
• Sleep deprivation

The symptoms of vestibular migraine usually build up over the course of a few hours and can last anywhere from 5 minutes to 72 hours. As vestibular migraine episodes can be quite intense, they can leave you feeling tired and drained for hours after the actual episode. 1

The diagnosis of vestibular migraine is made by a vestibular migraine specialist. This can be an ear, nose, and throat physician or a neuro-otologist, who is an expert on conditions causing imbalance and dizziness. In order for your specialist to diagnose you with vestibular migraine, some vestibular migraine diagnostic criteria will be assessed: 1

• You’ve suffered from at least 5 different episodes
• You have a history of migraine
• You experience vestibular migraine symptoms that last between 5 minutes and 72 hours
• You experience a migraine headache or other symptoms of migraine in at least half of these episodes

Besides assessing these characteristics, your physician will also perform tests in order to rule out other vestibular disorders such as Meniere’s disease. 1

Vestibular migraine treatment consists of lifestyle alterations to avoid the triggers of this type of migraine. Preventative vestibular migraine medication can also be recommended by your physician. Some examples are:  1

• Amitriptyline
• Propranolol
• Candesartan
• Flunarizine

During an acute attack of vestibular migraine, other medication may be recommended. This may include migraine-specific medication, triptans, or non-steroidal anti-inflammatory drugs. 

Vestibular migraine is also referred to as: 1

• Migrainous vertigo
• Migraine-related dizziness
• Migraine with prominent vertigo

Vestibular migraine is a type of migraine which causes vertigo. This may include symptoms of dizziness, imbalance, or a sensation of motion or the room spinning around you. The symptoms of vestibular migraine can be quite debilitating, which highlights the importance of discussing preventative treatments or lifestyle alterations with your physician. 

Q: What is a vestibular migraine? 
A: A vestibular migraine is a common type of migraine which causes symptoms such as vertigo, imbalance, and dizziness. Besides these symptoms, you can also experience regular symptoms of migraine, such as headache, nausea, and sensitivity to light and sound. 

Q: What can be mistaken for vestibular migraine? 
A: There are many other vestibular disorders such as Meniere's disease which can cause similar symptoms of vertigo. Your physician will run tests and ask you questions about your medical history and your symptoms in order to provide you with the correct diagnosis. 

Q: Is vestibular migraine a disability? 
A: Vestibular migraine can be very disabling as it can cause severe symptoms. Depending on the country you live in, you may be eligible for disability. 

Q: What are foods to avoid when suffering from vestibular migraine? 
A: If you suffer from vestibular migraine, then it is recommended to avoid dairy products, alcohol, caffeine, sugar, chocolate, and processed meats as they may trigger your vestibular migraine. 

Q: What is the best medication for vestibular migraine? 
A: Preventative medication for vestibular migraine may include amitriptyline, propranolol, candesartan, or flunarizine. During acute attacks, your physician may prescribe you with migraine-specific medication, triptans, or non-steroidal anti-inflammatory drugs.