Vestibular Migraine
Comprehensive guide to managing vestibular migraine through specialized exercises, lifestyle changes, and rehabilitation strategies.
Vestibular migraine is the second most common cause of dizziness, affecting around 3% of the general population. It has a bimodal presentation that may be associated with hormonal components in women.
Key Symptoms
Primary Symptoms
- •Vertigo or dizziness lasting minutes to days
- •Balance problems
- •Nausea and motion sensitivity
- •Visual disturbances
- •Head pressure or pain (not always present)
Associated Features
- •Sensitivity to light and noise
- •Neck stiffness
- •Anxiety about symptoms
- •Brain fog or confusion
- •Fatigue
Types and Presentations
Definite Vestibular Migraine
Meets strict diagnostic criteria with clear episodes of vertigo related to migraine symptoms.
- •At least 5 episodes lasting 5 min to 72 hours
- •Current or past history of migraine
- •One or more migraine features with at least 50% of episodes
- •Not better explained by another diagnosis
Probable Vestibular Migraine
Only partially meets diagnostic criteria but shows strong clinical correlation.
- •Fewer than 5 episodes
- •Doesn't fully meet migraine criteria
- •May lack typical migraine features
- •Still responds to migraine treatment
Common Triggers
Environmental
External factors that can provoke episodes
- •Bright or flickering lights
- •Loud noises
- •Strong smells
- •Weather changes
Lifestyle
Daily habits and routines that may trigger symptoms
- •Sleep disruption
- •Stress
- •Skipped meals
- •Dehydration
Motion-Related
Activities involving movement that can provoke symptoms
- •Car travel
- •Scrolling on devices
- •Rapid head movements
- •Crowded visual environments
Warning Signs
Seek Immediate Medical Care If You Experience:
- ⚠Sudden severe vertigo with hearing loss
- ⚠Double vision or vision loss
- ⚠Severe headache unlike previous ones
- ⚠Difficulty speaking or swallowing
- ⚠Weakness in arms or legs
- ⚠Loss of consciousness
- ⚠First episode of vertigo after age 50
- ⚠Vertigo with fever or neurological symptoms
Treatment Timeline
Initial Diagnosis
Comprehensive evaluation and treatment planning
- •Detailed medical history
- •Vestibular testing
- •Trigger identification
First 4-6 Weeks
Beginning treatment and lifestyle modifications
- •Starting preventive medications
- •Learning vestibular exercises
- •Implementing trigger avoidance
2-3 Months
Treatment optimization
- •Medication adjustments
- •Advanced exercises
- •Improved symptom control
6-12 Months
Long-term management
- •Stable treatment plan
- •Regular monitoring
- •Ongoing prevention strategies
Clinical Statistics
Prevention Strategies
Lifestyle Management
Regular routines help prevent episodes
Trigger Avoidance
Identifying and managing personal triggers
Stress Management
Stress can worsen symptoms and trigger episodes
Exercise Program
Regular vestibular exercises can improve stability
Care Team
Neurologist
Areas of Expertise:
- •Diagnosis confirmation
- •Medication management
- •Treatment planning
Vestibular Therapist
Areas of Expertise:
- •Vestibular rehabilitation
- •Balance training
- •Exercise progression
ENT Specialist
Areas of Expertise:
- •Rule out other causes
- •Inner ear assessment
- •Hearing evaluation