Vestibular migraine is a type of migraine. You experience dizziness, vertigo or imbalance lasting from minutes to days. This can happen with or without an actual headache. Vestibular migraines are a very common cause of episodic vertigo in both children and adults.
A person with vestibular migraines may have headaches without dizziness. They may also have dizziness without headaches.
Symptoms
Vestibular migraines can include a number of debilitating symptoms. They affect the balance, ears, and vision. Typically episodes of vestibular migraine last between 5 minutes and 72 hours. Symptoms can include:
- spontaneous vertigo
- intolerance to head movement
- motion sensitivity
- poor balance
- nausea
- ear pressure / tinnitus / noise sensitivity
- visual blurring / aura / light sensitivity
- headache (during or post)
- fatigue
- smell sensitivity
Diagnosis
A diagnosis is made based on a person’s medical history and a physical examination. Further testing may be required to rule out other vestibular conditions.
A past or a family history of migraines is linked to a higher chance of developing vestibular migraines. Some people report a childhood history of motion sickness or positional vertigo.
During a vestibular migraine episode, a person may have a nystagmus (involuntary eye movement). It can be assessed with specialised goggles. Vestibular migraines are often associated with anxiety, PPPD, fibromyalgia, and IBS.
A person may be referred to a neurologist to help make this diagnosis.
Management
Managing vestibular migraines often takes a range of health professionals. These include vestibular physiotherapists, neurologists, and psychologists. Best practice may include:
- vestibular physiotherapy — education, eye and head-movement exercises, balance exercises, exercises for motion and sensory tolerance
- lifestyle changes — sleep, exercise, diet
- anxiety and stress management
- medications
- trigger identification
Take this with you
This page is drawn from our Vestibular Migraine handout, which you can download and take to your GP or specialist.
Download the Vestibular Migraine handout (PDF)