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Dizziness headaches symptoms: Vestibular Migraines: Causes, Symptoms, Treatments


Vestibular Migraines: Causes, Symptoms, Treatments

A vestibular migraine is a nervous system problem that causes repeated dizziness (or vertigo) in people who have a history of migraine symptoms. Unlike traditional migraines, you may not always have a headache.

There are many names for this type of problem. Your doctor might also call it:

  • Migraine-associated vertigo
  • Migrainous vertigo
  • Migraine-related vestibulopathy


What Are the Symptoms?

Vestibular migraines don’t always cause headaches. The main symptom is dizziness that comes and goes. Vestibular refers to the inner ear, which controls your hearing and balance. If you’re having a vestibular migraine, you may feel:

  • Dizziness that lasts more than a few minutes
  • Nausea and vomiting
  • Balance problems
  • Extreme motion sensitivity — feeling sick or dizzy when you move your head, eyes, or body
  • Feeling disoriented or confused
  • Feeling unsteady, like you’re in a rocking boat
  • Sensitivity to sound

You could get dizzy and have balance problems without having a migraine at all. Other times, the vertigo symptoms happen before, during, or after the headache. Sometimes, you might have migraines for years before the vertigo symptoms begin.

What Causes Them?

Doctors aren’t sure. Like migraines, there are a lot of theories. But how it really happens is poorly understood. They credit it to misfires between nerve cells in your brain.

Who Gets Them?

It’s hard to tell how many people are living with this condition. The symptoms mimic a lot of other diseases. Researchers think they affect about 1% of the population. But that number could be higher.

Like traditional migraines, they’re more common in women than men. Vertigo symptoms tend to first strike around age 40. But the condition doesn’t just affect adults. Kids can get it, too.

How Are Vestibular Migraines Diagnosed?

There’s no blood or imaging test that can tell for sure. But the International Headache Society and other organizations recently set up the first criteria to help your doctor diagnose the disorder.

You could be having a vestibular migraine if:

  • You have migraines or had them in the past.
  • You have at least 5 episodes of vertigo that make you feel like you are spinning or moving. This isn’t the same as motion sickness or feeling faint.
  • These feelings last between 5 minutes to 72 hours.
  • Your symptoms are moderate to severe. That means they stop you from doing everyday tasks or they’re so bad you can’t do anything at all.
  • At least half of the episodes happen with one of the following migraine symptoms:
    • A headache that has two of these characteristics: is one-sided, pulsing, moderate to severe, or gets worse with activity
    • Sensitivity to light or sound
    • Seeing shimmering or flashing lights in your vision (a migraine aura)

How Does My Doctor Rule Out Something Else?

They’ll likely order an MRI to check your brain and run hearing and balance tests to look for problems with your ears.

  • Meniere’s disease. Before you get dizzy, usually one of your ears feels full or stuffy, or hurts. During an attack, one or both ears may ring, or you might lose hearing. This doesn’t usually happen with a vestibular migraine.
  • Brainstem stroke. Along with vertigo, you mayalso have numbness, weakness, trouble speaking, and other stroke symptoms. If you have any of these symptoms, or if you have new vertigo that has not been diagnosed, get immediate emergency help.

How Are They Treated?

There’s no specific medication for vestibular migraines. Your doctor will prescribe different drugs to stop an attack when it happens. This is called abortive therapy.

  • Triptans. Take these migraine meds at the first sign of headache symptoms.
  • Vestibular suppressant. It can ease your dizziness and motion sensitivity. This type of drug works on the balance center in your inner ear. Your doctor might prescribe benzodiazepines like lorazepam (Ativan), anti-nausea drugs like promethazine and antihistamines like meclizine.
  • If you have frequent or disabling vestibular migraines, your doctor may try drugs similar to traditional migraine prevention meds. You take these regularly to reduce the severity or frequency of the headaches. These include seizure medicines, blood pressure medicines (like beta blockers and calcium channel blockers), and some antidepressants. CGRP inhibitors are a new class of preventive medicine that your doctor may recommend if other medicines don’t help.

If you have frequent or disabling vestibular migraines, your doctor may try drugs similar to traditional migraine meds. They include:

  • Antiseizure drugs like gabapentin (Gralise, Horizant, Neurontin), topiramate (Qudexy XR, Topamax, Topamax Sprinkle, Trokendi XR), or valproate (Depakote, Depakene, Stavzor).
  • Blood pressure medicines
  • Tricyclic antidepressants – amitriptyline, nortriptyline (Aventyl, Pamelor)
  • SSRIs – citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra), paroxetine (Paxil, Pexeva), and sertraline (Zoloft)
  • SNRIs – duloxetine (Cymbalta, Irenka) and venlafaxine (Effexor)

There is the possibility of getting relief through use of some devices.

  • Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
  • SpringTMS or eNeura sTMS, a device which can be held at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain. 
  • gammaCore is a hand-held portable device which is a noninvasive vagus nerve stimulator (nVS). When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
  • A remote electrical neuromodulation called Nerivio is also available, but unlike the other three it is approved for treatment only and not for both prevention and treatment.

Can Diet Changes Help Prevent Attacks?

Knowing your headache triggers may help you ward off migraine-related vertigo. Things like chocolate, cheese, alcohol, and foods with the preservative MSG are triggers for some people. If you have vestibular migraines, these things might trigger your symptoms, too. It can’t hurt to cut them from your diet to see if your symptoms ease up a bit.

Tracking your diet is another good way to help tell if your vertigo symptoms are really due to headaches. For example, a high-salt diet can make vertigo symptoms worse if you have Meniere’s disease. Keep a food diary and show it to your doctor. It can help improve your diagnosis and treatment.

Migraines & Headaches with Dizziness, Vertigo, or Vision Problems

Many people who get migraines also have problems with their vision as well as dizziness or vertigo along with the headaches.

These effects can be scary and troubling. But they usually get much better or even disappear with treatment. Lifestyle changes, medications, and complementary therapies can help migraines and their related symptoms.

Vision Problems

About 1 in 4 people who suffer from migraines will get an aura, which often includes visual symptoms:

  • Blind spots
  • Flashing lights
  • Spots of light
  • Wavy lines in your field of vision

Vision problems usually start 20 minutes to an hour before the headache. Even if you don’t get an aura, the headache itself may cause vision trouble.

A retinal migraine causes a variety of visual symptoms, possibly blindness in one eye, before and during the headache. Fortunately, these problems go away with it, but permanent vision loss may be a complication of this type of migraine.

Other serious conditions, such as optic nerve problems or a tear in the arteries that supply blood to your brain, can also cause one-sided blindness. See your doctor as soon as you can to rule them out.

Vertigo and Dizziness

Migraines are one of the leading causes of dizziness. About one-fourth of the people in the U.S. who have migraines get this uncomfortable symptom. Dizziness and vertigo are more common when you have migraines with aura.

You may feel lightheaded or unsteady — vertigo makes it seem like the room is spinning. It may happen before or at the same time as the headache. Sometimes you won’t get a headache at all. The symptoms may last anywhere from a few seconds to days.

The sensations are actually related to your inner ear. In fact, some people who have vertigo with their migraines also have other ear and hearing problems such as sound sensitivity and ringing in their ears.

A basilar-type migraine, what doctors call migraine with brainstem aura (MBA), is the most likely to cause vertigo. It’s also likely to cause ringing in the ears, hearing loss, and coordination difficulties.

Some people who have migraine-related vertigo don’t get this symptom until several years after their headache episodes begin.

Doctors have a hard time diagnosing vertigo caused by migraine. That’s because people who have these headaches often have other conditions that may cause dizziness, too, including anxiety, and low blood pressure related to their body position.

Treatment for Migraines and Related Symptoms

Many people can lessen or get rid of their headache and its problems by changing their daily habits:

No surefire medication will work for everyone who gets migraines. But you have options that, alone or in combination, can relieve the headaches and associated vision issues, dizziness, and vertigo.

Some prescriptions block migraines before they start.

  • Amitriptyline (Elavil, Endep), an antidepressant
  • Topiramate (Topamax), a seizure medication
  • Verapamil (Calan, Calan SR, Covera HS, Verelan, Verelan PM), also used for high blood pressure, chest pain, and irregular heart rhythm
  • Eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) are CGRP inhibitors  that blocks the effects of calcitonin gene-related peptide molecules

Your doctor may prescribe drugs called triptans, including rizatriptan (Mazalt) and sumatriptan (Alsuma) to stop migraines before they become full-blown.

A new class called ditans which includes lasmiditan (Reyvow) may be a safer option if you are older or have certain heart problems. Gepants such as rimegepant (Nurtec) and ubrogepant (Ubrelvy) block CGRP to help stop migraines in their tracks.

There are a couple of devices designed to short-circuit a migraine by turning on your brain in a particular way. A device called SpringTMS uses a technique called a transcranial magnetic stimulation (TMS). Place it on the back of your head for about a minute for release of a pulse of magnetic energy. Similarly, Cefaly uses transcutaneous supraorbital nerve stimulation and is worn as a headband on the forehead and turned on daily for 20 minutes to prevent migraine from developing. There is also a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve’s fibers to relieve pain. These three devices can be used to both prevent and treat migraines. A remote electrical neuromodulation device called Nerivio is also available for treatment of migraines only.

You’ll need a prescription for any of these gadgets, too.

Both prescribed and over-the-counter pain relievers and anti-inflammatory drugs, such as acetaminophen, ibuprofen, and naproxen, may give you relief from the migraine’s effects.

Biofeedback and acupuncture can help you manage your stress as well as headache pain and other sensations.

Vestibular Migraine | Johns Hopkins Medicine

Migraine headaches are a common neurological condition. Although common migraines are characterized by a moderate to severe pounding or throbbing headache, vestibular migraine may or may not involve headaches in combination with vestibular symptoms such as vertigo, imbalance, nausea and vomiting.

Vestibular Migraine Symptoms

Although subjective hearing symptoms (ringing, fullness, pressure in one or both ears) are common, significant hearing loss should raise suspicion for an inner ear disorder such as Méniére’s disease.

With a vestibular migraine, the person may experience a combination of vestibular attacks, visual aura, or sensitivity to visual stimulation and motion at different times, and they can occur with or without an actual headache.

What causes vestibular migraine?

Vestibular migraines, like other migraine syndromes, tend to run in families. Although science has not completely clarified the complex mechanisms of migraine, it is known that women tend to suffer more from the condition than men, and symptoms may get worse around menstruation.

In addition, people vulnerable to vestibular migraines can experience episodes after migraine triggers including altered sleep patterns, MSG, menstrual cycle and food such as chocolate, ripened or aged cheese and red wine.

Vestibular Migraine Diagnosis

Because a majority of people who have vestibular migraine do not have vestibular symptoms and headaches occurring at the same time, the onset of dizziness by itself may make it challenging to arrive at a diagnosis. Other diagnostic considerations that can present similarly to vestibular migraine include:

It is common for vestibular migraine, Méniére’s disease and BPPV to coexist, which can make diagnosis and treatment even more challenging.

Vestibular Migraine Treatment

Treatment for vestibular migraine is similar to that for other migraine headaches. Use of meclizine or other abortive medications that suppress the vestibular system should be minimized, and only used occasionally as needed, during an episode for instance.

If the person is getting frequent attacks, the doctor may recommend one or more of these medications, as well as others:

People with vestibular migraines can reduce the number and intensity of episodes by maintaining a regular sleep and meal schedule, avoiding triggers, exercising regularly and managing stress.

Dizziness (lightheadedness) – Illnesses & conditions

Dizziness is a common symptom that’s not usually a sign of anything serious, but should be investigated by a doctor.

The term “dizziness” means different things to different people – some use it to describe feeling lightheaded or off balance, while others use it to describe a feeling that their surroundings are spinning.

Because the symptom is quite vague and can be caused by a wide range of things, it may not always be easy to identify the underlying cause of dizziness.

This page explains what you should do if you feel dizzy for no apparent reason, and outlines the most common causes.

Seeing your GP 

See your GP if you’re feeling lightheaded or off balance and you’re worried, particularly if you also have other symptoms, such as fainting episodes or headaches.

Your GP will first want to establish exactly what you mean by dizziness, and check that you’re not actually describing vertigo – a severe type of dizziness, where you feel your surroundings are spinning or moving.

They’ll also want to know:

  • whether the dizziness started for no apparent reason, or if it followed an illness
  • whether you have repeated episodes of dizziness and, if so, when you tend to experience these
  • how long the dizziness lasts

Dizziness can sometimes be caused by an ear condition. A simple way of distinguishing between ear-related dizziness and dizziness due to other causes is to determine whether it occurs only when you’re upright or also when you’re lying down.

Dizziness that occurs when you’re upright is probably not related to the ear. Dizziness that happens when you’re lying down is usually caused by a viral ear infection, which can’t be treated with antibiotics.

It’s a good idea to keep a diary of your dizziness, recording when and where you experience the problem, and take it with you to your GP appointment. It’s helpful to note:

  • what you were doing at the time of your dizziness
  • how long it lasted and how bad it was
  • whether you had any other symptoms – such as fainting, vomiting, nausea, blurred vision, headache, hearing loss or tinnitus

If you’re taking prescription medicine, your GP will probably review this to check whether dizziness is a possible side effect. If necessary, they can prescribe a different medication for you to try.

You may be referred to a specialist for further tests and investigations.

Common causes of dizziness

The most common causes of dizziness are outlined below.

  • Labyrinthitis – an inner ear infection that affects your hearing and balance, and can lead to a severe form of dizziness called vertigo.
  • Migraine – dizziness may come on before or after the headache, or even without the headache.
  • Stress or anxiety – particularly if you tend to hyperventilate (breathe abnormally quickly when resting).
  • Low blood sugar level (hypoglycaemia) – which is usually seen in people with diabetes.
  • Postural hypotension – a sudden fall in blood pressure when you suddenly sit or stand up, which goes away after lying down. This is more common in older people.
  • Dehydration or heat exhaustion – dehydration could be due to not drinking enough during exercise, or illness that causes vomiting, diarrhoea or fever.
  • Vertebrobasilar insufficiency – decreased blood flow in the back of the brain, which may be caused by the blood vessels that lead to the brain from the heart being blocked (known as atherosclerosis).

Less common causes of dizziness

Less common causes of dizziness include:

3 Common Treatments for Vestibular Migraines – Cleveland Clinic

When you think “migraine” you probably think “headache.” But if you have a history of migraine headaches and start having dizzy spells, you may have vestibular migraines — and they’re a bit of an oddity; they may not involve headaches at all.

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A history of migraines and dizziness are clues to this condition, but diagnosing vestibular migraines isn’t as straightforward as that, says neurologist Neil Cherian, MD.

“It’s like saying that if a car is fast and red it must be a Ferrari,” he says.

What is a vestibular migraine?


Doctors look for at least a five- to eight-year history of migraine symptoms and developing dizziness to identify vestibular migraines (also known as migraine-associated vertigo, migraine-related vestibulopathy and migrainous vertigo). The term “vestibular” refers to the inner ear and your sense of balance.

“The vestibular symptoms are quite variable,” Dr. Cherian says. “They could include a spinning feeling, a sensation of movement and the perception that things are moving out of proportion to the environment.”

Symptoms can last for minutes or days. And, they can knock you off your feet.

“Vestibular migraines can be quite debilitating,” he says. “Even though there is not always a headache, the dizziness, light and sound sensitivity, and/or the nausea are sometimes quite incapacitating.”

It’s difficult to say how common vestibular migraines are. One study suggests that 1.7 percent of the general population may have them.

”The research on this is still evolving,“ Dr. Cherian says. “In my 18 years of practice, I have not seen many cases.”

How do vestibular migraines differ from classic migraines?

A migraine headache causes moderate to severe pain and tends to recur. The pain often begins on one side of the head and throbs or pulses. You may notice sensitivity to light, sound and odors. You may experience nausea and vomiting.

Some people notice a warning signal or aura (visual cues such as bright flashing lights, for example) before a migraine.

They tend to run in families, but there are other triggers — emotional stress, sensitivity to chemicals and preservatives in food, caffeine, and sleep deprivation.

Vestibular migraines mirror many of these symptoms along with dizziness (with or without a headache). Dr. Cherian says he looks for the absence of signs of an inner ear problem or other possible sources of dizziness to help make a diagnosis.

How does dizziness factor in?

Dizziness by itself is a common ailment. About 15 percent of the general population experiences dizziness each year, and the rate is higher among older adults.

“It’s one of the top five presenting symptoms to a primary doctor,” Dr. Cherian says.

It causes falls and faintness in some cases, but with vestibular migraines you’ll have vertigo or a sense of spinning.

Dizziness is generally not serious, and may relate to medications or heart problems as well as inner ear problems (with vestibular migraines), he says.

How do doctors treat vestibular migraines?

“Typically, we treat migraines and vestibular migraines the same,” Dr. Cherian says.

He suggests three common approaches:

  1. Determine and avoid your triggers — stress, certain foods or not enough sleep.
  2. Take supplements, such as riboflavin or magnesium.
  3. Take over-the-counter or prescription drugs to reduce pain or prevent headaches.

Your doctor also may prescribe vestibular rehabilitation, a type of physical therapy that can help improve balance and manage your dizziness.

The rehabilitation team will tailor an exercise plan for your specific problems, including exercises for neck stretching and vision stability, for example.

Bottom line? Don’t try to diagnose yourself. Explain your headache history and symptoms and let your doctor determine whether you’re having vestibular migraines.

Vestibular migraine – Royal Victorian Eye and Ear Hospital

Vestibular migraine or migrainous vertigo is a type of migraine that may or may not cause a headache, but can include a number of debilitating symptoms affecting the ears, vision and balance. It is the second most common cause of vertigo.

What do the symptoms of vestibular migraine feel like?

Alongside symptoms of vertigo, imbalance and dizziness, during a vestibular migraine some sufferers may also find head movement involved in turning, bending down or looking up intolerable, feel a pressure within their head and/or ear, have neck pain, find it hard to hear low sounds, or develop tinnitus (a ringing or other sound in the ear). People may also experience headaches, visual disturbances such as hazy or blurred vision, sparkles or blotches in their vision, or loss of part of their vision.

What causes vestibular migraine?

The cause of vestibular migraine is not completely understood. However, it is thought that it is caused by abnormal ‘electric’ messages, which lead to a widening of the blood vessels in and around the brain, including the vestibular artery in the inner ear’s balance control system.

How is a diagnosis made?

If referred to a specialist by your GP, a diagnosis of your condition will be made based on your medical history, answers to questions about when and where the symptoms occur, and a physical examination.

How is vestibular migraine treated?

Treatment of vestibular migraine can include:

  • preventative medications if the regularity and severity of symptoms are interfering with your life
  • medication to relieve symptoms
  • making lifestyle changes to remove the symptom triggers, such as alcohol, not enough sleep, or stress.

Preventative medications may be prescribed and these need to be taken every day whether or not you feel unwell. Migraine episode treatments may also be prescribed, including pain relief medication and anti-nausea medication. Vestibular rehabilitation/physiotherapy has been shown to be effective if symptoms of movement-provoked dizziness, or imbalance, persists between episodes of migraine. For more information about vestibular physiotherapy, including how to access a vestibular physiotherapy service, please click here.

Living with vestibular migraine

For almost all patients, the combination of a healthy lifestyle and medication (if necessary) will lead to a good recovery from migraines and resumption of normal activities. Lifestyle changes that reduce or prevent migraines in some people include:

  • regular exercise
  • avoiding the food and drink that triggers migraine (such as caffeine or alcohol)
  • maintaining an adequate fluid intake
  • consistent sleep patterns.

Online resources

The Vestibular Disorders Association is a US-based, patient support group. Their website contains useful information about how to understand, live with and find support for balance disorders. Visit www.vestibular.org

Definition of vestibular migraine medical terms

Vestibular system: a part of the inner ear that sends information about the position of the head to the balance control centre in the brain. See How does the balance system work? for more information.

Migraine: a chronic, generally periodic, neurological disorder, which may involve headaches and a number of associated and temporarily disabling symptoms.

Vertigo: a false sensation that you or your surroundings are moving.

Tinnitus: a subjective sound in the ear (such as ringing, buzzing, hissing or rumbling) that is not associated with any external sound.

What is Vestibular Migraine? | Ménière’s Society

Migraine does not mean headache.  In fact, there are many types of migraine that involve no headache at all, it just so happens that the two most common types of migraine in the population are the headache varieties; common migraine and classical migraine.

Migraine is actually a condition of altered sensation and can happen at any age and in any part of the body. Young babies may present with migraine in the form of cyclical vomiting. Children present with abdominal migraine having tummy pains and diarrhoea, and adults can also have abdominal migraine, but we know it by a different name – irritable bowel syndrome (IBS).  Migraine can also present as motion sickness, facial pain and joint pains without any headache at all.

Vestibular migraine is now the internationally accepted term for a type of migraine that mainly presents with dizziness symptoms. The duration of attacks are very variable, from seconds in some patients to days in others, but usually last minutes to hours.They mostly occur without headaches, although in around half of patients are followed by or occur with a headache or visual changes.

Vestibular migraine is typically associated with nausea, vomiting, sweating, flushing, diarrhoea and visual changes such as blurring, flashing lights and difficulty focusing. Patients also report difficulty concentrating, finding bright lights and loud sounds uncomfortable and, most commonly, feel extreme tiredness and fatigue, needing to sleep.

Who is affected by vestibular migraine?

Vestibular migraine is the most common cause of recurrent spontaneous vertigo and the second most common vestibular disorder after benign paroxysmal positional vertigo (BPPV). It affects about 10% of all migraineurs. Vestibular migraine may start at any age and has a female preponderance of about 3:1. Familial occurrence is common, pointing to a genetic origin of the disorder.

There is a strong association with Ménière’s disease, with approximately half of people with Ménière’s experiencing at least one migraine symptom during a Ménière’s attack. The two conditions can coincide in 40% of patients with Ménière’s disease.  Vestibular migraine must always be considered in any patient with Ménière’s whose symptoms recur unexpectedly and before any destructive Ménière’s treatment is contemplated.

Benign paroxysmal vertigo of childhood designates a variant of vestibular migraine that starts at pre school age with brief attacks of isolated vertigo which tend to be replaced by typical headache migraine after a few years.

How is vestibular migraine diagnosed?

Vestibular migraine is diagnosed on the basis of patient’s history. The commonest (benign) neurological condition to mimic BPPV is a form of migraine. Attacks can last seconds, minutes, hours or even days in some patients and are often not associated with headache. The presence of concurrent symptoms not expected in Ménière’s disease such as visual symptoms during attacks is often the key to the diagnosis. This may include blurred vision or sensitivity to light. Patients also often complain of extreme fatigue immediately following an attack.

Incidentally, vestibular migraine can cause attacks which are not unlike those of Ménière’s and which are often misdiagnosed as such without expertise!

Vestibular migraine is also known as migrainous vertigo, migraine-associated dizziness, migraine-related vestibulopathy, and recurrent vertigo, however the internationally accepted term (of the Barany Society) is vestibular migraine.

How is vestibular migraine treated?

Migraine in general has been shown to be closely related to anxiety and depression and the most common cause is stress!  Most patients have one or more specific triggers and treatment therefore centres on identifying and managing these triggers in individual patients.

The top 5 most common triggers for vestibular migraine are;

  1. Stress and anxiety.
  2. Poor sleep – both too little, and too much!
  3. Hunger and dehydration – missing meals and not taking enough water.
  4. Dietary triggers – many common foods, especially caffeine.
  5. Hormonal changes – i.e. menstruation, menopause and in teenagers.

Other external triggers can include certain forms of lighting and ventilation, weather changes, smoking and strong odours.

Initial treatment is education, with the systematic identification of trigger factors with a symptom diary.  Regulation of lifestyle is often the key, but the good news is that simple lifestyle and dietary changes have been shown to help in 80-90% of patients! Medication is only needed in a minimal number of patients.

Further information about vestibular migraine

Please contact us for further information about vestibular migraine or to chat with a member of our team. Further information about vestibular migraine is also available at vestibularmigraine.co.uk (please note this is an external link and not produced by the Ménière’s Society).

If you have found our information helpful, why not become a member. As well as supporting our work, we’ll keep you informed about the latest management/treatment options for vestibular disorders and what research is taking place. Find out more about membership.

If membership isn’t for you, please consider making a donation towards our work so we can continue supporting people affected by endolymphatic hydrops and other vestibular disorders, as well as funding vital research into these conditions. Donate Now!

Headache – causes, examination and treatment | Symptoms

Cluster headache
Signs: Severe, stabbing pain that affects one part of the head and is concentrated in the periocular region, usually lasts from 30 minutes to 1 hour, often occurs at the same time of day, occurs in clusters and is separated by intervals with a complete absence of headache. usually not aggravated by light, sounds, or odors, and is not accompanied by vomiting.Inability to lie down and restlessness. From the side of pain: runny nose, lacrimation, drooping eyelid (Bernard-Horner syndrome) and sometimes swelling under the eye.

Migraine headache
Signs: Moderate to severe headache, usually throbbing, one-sided and two-sided, lasting several hours to several days, may be caused by lack of sleep, head injury, hunger or certain wine and food intake, may worsen with physical activity and decrease after sleep. often accompanied by nausea, vomiting, and sensitivity to loud sounds, bright lights, and / or odors, including mood changes, loss of appetite, and nausea, sometimes preceded by temporary disturbances in sensitivity, balance, muscle coordination, speech, or vision (flashes or blind spots ).

Tension headache
Signs: Usually mild to moderate headache that feels like a tight hoop and starts in the front of the head or around the eyes, affects the entire head, lasts for 30 minutes to several days, may get worse at the end of the day, does not get worse with physical exertion, exposure to light, sounds, or odors, is not accompanied by nausea, vomiting, or other symptoms.

Altitude sickness
Signs: Dizziness, loss of appetite, nausea and vomiting, fatigue, weakness, irritability, or trouble sleeping.People who have recently climbed to high altitudes (including those who have been on an airplane for 6 hours or longer).

Brain tumor, abscess or other neoplasm in the brain
Signs: Mild to severe headache, which can get worse, usually occurs more often and eventually becomes constant with no signs of relief, can lead to blurry vision with a sudden change in body position, can be accompanied by clumsiness, weakness, disorientation, nausea, vomiting, seizures, or visual impairment.

Exposure to carbon monoxide
Signs: Possibly unaware of exposure as carbon monoxide is colorless and odorless.

Tooth infection (upper teeth)
Signs: Pain that is usually felt in the facial area and is mainly one-sided, worse when chewing, toothache.

Encephalitis (brain infection)
Signs: Headaches with variable characteristics. Often accompanied by fever, increased drowsiness, disorientation, agitation, weakness, and / or poor coordination.Seizures and coma.

Giant cell (temporal) arteritis
Signs: One-sided throbbing pain in the temporal part of the head. Pain when combing hair or while chewing. Sometimes enlarged arteries in the temples (temporal arteries) and aching and dull pains, especially in the shoulders, hips, and pelvis. Possible visual impairment or loss, more common in people over the age of 55.

Glaucoma (angle-closure glaucoma)
Signs: Moderate to severe pain that occurs in the front of the head or in the eye or eye area. Eye redness, iridescent circles around light sources, nausea, vomiting, and loss of vision.

Head trauma (post-concussion syndrome)
Signs: Headache begins immediately or shortly after a head injury (with or without loss of consciousness). Sometimes blackouts, character changes, or both.

Idiopathic intracranial hypertension (increased intracranial pressure)
Signs: Headaches that occur daily or almost daily with fluctuating intensity, affecting both sides of the head, sometimes double vision or blurred vision, nausea or ringing in the ears in rhythm with a beat of the pulse (pulsating tinnitus).

Brain hemorrhage
Signs: Mild to severe pain that begins suddenly, on one or both sides of the head, often accompanied by nausea and sometimes vomiting. There may be severe drowsiness, clumsiness, weakness, difficulty speaking and understanding speech, loss of vision, loss of sensation or disorientation, occasionally seizures or coma.

Headache associated with low pressure (occurs as a result of the removal of cerebrospinal fluid or its leakage)
Signs: Intense headaches, often accompanied by a stiff neck and nausea.Pain that is worse when the person is sitting or standing and is weaker when the person is lying down. Usually occurs after a spinal tap (lumbar puncture) is performed.

Headache due to excessive drug use
Signs: Chronic and often daily headaches. Often with migraines or tension headaches

Signs: Severe, persistent headache. fever, rigidity of the occipital muscles, in connection with which it is painful to lower the chin to the chest, is sometimes impossible.Malaise, drowsiness, nausea, or vomiting.

Signs: Pain that is sometimes felt in the face, front of the head, or as a toothache may start suddenly and last for days or hours, or it starts gradually and becomes persistent. Runny nose, sometimes with pus or blood, malaise, cough at night, and often a fever.

Subarachnoid hemorrhage (bleeding between the inner and middle layers of tissues covering the brain)
Signs: Severe, persistent pain that starts suddenly and reaches its maximum intensity within a few seconds is often described as the worst headache ever experienced.There may be a brief loss of consciousness at the onset of the headache, drowsiness, disorientation, difficulty waking up, or coma are possible. Stiff neck, nausea, vomiting, dizziness, and back pain.

Subdural hematoma (accumulation of blood between the outer and middle layers of tissues covering the brain)
Signs: Headaches with variable characteristics. Drowsiness, disorientation, forgetfulness and / or weakness or paralysis on one side of the body may occur.

Diseases of the temporomandibular joint
Signs: Pain when chewing solid food; Sometimes pain in the jaw or nearby area or in the neck, sometimes clicking or crackling when opening the mouth, blocking the position of the jaw, or difficulty trying to open the mouth wide.

Dizziness and headache – a: care

Severe headache can disrupt your daily routine. It does not allow us to enjoy the best moments from which the happiest memories should have formed.Headache not only alters our perception, but also reduces our ability to concentrate, impairs memory, and negatively affects work performance and relationships with colleagues. [1] [2]

Headache in scientific language is called cephalalgia. It is usually divided into three categories:

  • tension headache (HDN) is pain caused by muscle tension;
  • migraine – severe headache with a very complex mechanism of development;
  • headache caused by a disease.[3]

Most often the headache is due to the tension of the pericranial muscles. [4] HDN accounts for 80-90% of all headache cases. [3] It can occur, for example, if you overwork in the gym or sit for a long time at the dentist in an uncomfortable position.

Migraine affects approximately 20% of the population. [1] Moreover, women have it 3-4 times more often than men. [1] [5]

Sometimes, before the onset of a migraine, a person feels her approach, the so-called “aura”.Its symptoms are nausea, dizziness, weakness, tinnitus, etc. [6] Recent studies have found that a person’s predisposition to migraine depends on the presence or absence of certain genes. [7]

The main difference between HDN and migraine is that tension headache arises and develops gradually, and a migraine attack – almost always suddenly and in the presence of other symptoms. There is also a mixed headache, in which there are signs of both migraine and HDN.[3]

Headache in itself can greatly complicate a person’s life, but it is often accompanied by other unpleasant symptoms, such as dizziness.

Unlike headache, dizziness is always a symptom of some other disease or condition, but a headache can also be an “alarming signal” of the body.

What diseases contribute to dizziness or headache? [8]

Most often it is:

  • head trauma,
  • cervical osteochondrosis,
  • vegetative-vascular dystonia,
  • hypertension,
  • brain tumor,
  • meningitis,
  • stroke,
  • flu or cold,
  • diseases of the inner ear, etc.

Both dizziness and headache can be psychogenic, i.e. arise from emotional distress. [3]

Treatment of dizziness and headache

To cure dizziness and headache, it is necessary, first of all, to find out the cause that causes them. This can only be done by a specialist. In addition to drug therapy, diet and prevention of vertigo are important for the success of treatment. They include good rest, smoking and alcohol cessation, special gymnastics and, if necessary, psychological assistance.Some medications can also provoke a headache, so it is not safe to self-medicate, it is much better to immediately consult a doctor. [1]

Be attentive to your health and remember that any disease is much easier to cure at an early stage!

List of used literature:

1. Vorobieva OV Treatment of migraine headache // Nervous diseases. – 2014. – No. 2. – S. 2-5.

2. Kuznetsova EA, Yakupov EZ Changes in cognitive evoked potentials (p300) in chronic daily headaches // Kazan Medical Journal.- 2011. – T. 92. – No. 1. – S. 17-19.

3. Zelenkina S. Massage for migraines. M .: Veche, 2003 .– 205 p. – https://www.e-reading.club/chapter.php/69012/3/Zelenkina_-_Massazh_pri_migreni.html (Access date: 25.06.2016).

4. Tabeeva GR, Azimova Yu. E. New in the treatment of episodic tension headache // Neurology, neuropsychiatry, psychosomatics. – 2010. – No. 4 – S. 57-62.

5. Amal Mattu; Deepi Goyal; Barrett, Jeffrey W .; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M.Garmel; Richard Harrigan; David Karras; Anita L’Italien; David Manthey. Emergency medicine: avoiding the pitfalls and improving the outcomes. – Malden, Mass: Blackwell Pub./BMJ Books, 2007. – P. 39.

6. Zamergrad MV Vestibular disorders in neurological and general medical practice // Modern therapy in psychiatry and neurology. – 2012. – No. 2. – S. 20-26.

7. Piane, M; Lulli, P; Farinelli, I; Simeoni, S; De Filippis, S; Patacchioli, FR; Martelletti, P (December 2007).Genetics of migraine and pharmacogenomics: some considerations. The journal of headache and pain 8 (6): 334-9.

8. Morris Levin, Steven M. Baskin, Marcelo E. Bigal. Comprehensive Review of Headache Medicine. – Oxford University Press US, 2008. – P. 60.

Co-author, editor and medical expert:

Volobueva Irina Vladimirovna

Born on September 17, 1992.


2015- Sumy State University, specialization “General Medicine”.

2017 – Graduated from an internship in the specialty “Family Medicine” and also defended her master’s work on the topic “Features of the development of antibiotic-associated diarrhea in children of different age groups.”

90,000 Dizziness, headache – signs of vascular aging


Collecting together the data of medical practice, the world’s luminaries in the field of medicine are increasingly declaring: “old age is getting younger”

And, although many perceive the phrase as a good pun, the meaning of the enigmatic maxim is rather sad.Based on the collected statistics, the first signs of old age appear at the age of 35, which is 15 years less than at the end of the 20th century.

Among the first signs of aging, doctors note dizziness, high fatigue and absent-mindedness – symptoms of oxygen starvation of brain cells. It is believed that forgetting and not noticing elementary things is peculiar to elderly people, and yesterday’s students only smile at the request of their grandmother to find glasses or a key. Indeed, dizziness and distraction often accompany degenerative changes in brain cells caused by impaired blood supply.Aging of blood vessels, which causes such phenomena, can begin at 35, and even earlier.

Nobody wants to grow old, so many people ignore dizziness and blackheads before their eyes, preferring to keep a diary as a panacea for forgetfulness. Unfortunately, this approach does not restore oxygen supply to the brain tissue, and cell hypoxia gradually leads to an increase in the symptoms of aging. In response to stress, alcohol and nicotine poisoning, chronic lack of sleep, headaches appear, bouts of lightheadedness in transport, and sometimes panic attacks occur.

In an effort to “cure everything with one pill”, many begin to buy “miraculous drugs” that can stop unpleasant symptoms. And only a few turn to a doctor in order to stop the premature aging of blood vessels in order to avoid problems such as Parkinson’s disease, dementia, and prevent coronary artery disease, cerebral atherosclerosis and other unpleasant consequences of impaired cerebral circulation. Meanwhile, it is quite possible to stop the aging of blood vessels at the initial stage.

Sholomov Ilya Ivanovich, neurologist, head of the Department of Nervous Diseases, S. IN AND. Razumovsky, Doctor of Medical Sciences, Professor:

“Dizziness and headache may be the first signs of problems with the vessels of the brain. Cerebral circulation disorders can be promoted by: increased blood pressure, stress, diseases of the spine, trauma. Of course, many people greatly overload the work schedule, and the lack of normal sleep, combined with emotional shocks, does not go unnoticed.Headaches, dizziness, memory loss during severe stress are a natural consequence of a busy lifestyle. As practice shows, massage and emergency medical care help to solve the problem “here and now”, however, without constant prevention, attacks of dizziness can become more frequent. To improve cerebral circulation and increase the resistance of brain tissues to hypoxia, which is inevitable in case of impaired blood supply, doctors use a number of drugs, including Vasobral, which provide a quick recovery of working capacity, improve metabolic processes in brain cells, thanks to the components that make up their composition.With regular use, there is a decrease in the permeability of the vascular walls, a decrease in the risk of vascular obstruction. The uniqueness of the action makes it possible to achieve a decrease in the frequency and strength of attacks of dizziness, and provides a prophylactic effect in case of migraine. ”

Along with drug therapy, it is customary to prescribe special diets and various restrictions. Of course, quitting smoking and alcohol will significantly improve the condition of the blood vessels, but you can start with simpler steps. For example,

1.Drink clean water every time you are thirsty. Dehydration often leads to dizziness, and metabolic processes slow down with a lack of fluid.
2. Sleep every day, in the dark, cool, with good ventilation and minimal noise. So the body will better rest and recover faster.
3. Add foods rich in calcium, magnesium, vitamin E to your menu: green vegetables, cheeses, nuts, vegetable oils.
4. Move as often as possible, more and more varied.Walking backwards along the corridor, jumping on one leg, joining your palms behind your back – any unusual activity will improve blood circulation.

Thus, even small changes in lifestyle and taking medications can avoid disturbances in the blood supply to brain cells and early degenerative changes.

90,000 Vestibular migraine: description of the disease, causes, symptoms, cost of treatment in Moscow

Vestibular migraine is not typical.With this form of pathology, the main complaint of the patient is not pain, but a sharp attack of dizziness, in which there is also a feeling of objects circling around. In most cases, there is a complete loss of orientation in space, which is especially dangerous for injury. Seeking medical help for such a pathology is mandatory.

The main manifestation of vestibular migraine is dizziness, which tends to increase or decrease with various head movements.Because of this, it is not uncommon for patients to start looking for a position in which they will be more comfortable at the time of an attack. The duration of an attack can range from a few minutes to several hours and vary in intensity. Since no structural changes are detected after an attack, we can say that the problem is a functional disorder, in which a temporary overexcitation of a separate part of the brain occurs, after which the patient’s condition is fully restored.


The reasons why the pathological condition itself develops and dizziness occurs directly with vestibular migraine has not been established. Many doctors today are of the opinion that the pathology is caused by a violation in the work of the vessels of the brain. There is no exact confirmation of this version yet. The reasons that provoke the development of an attack are:

  • strong emotional stress, which can be associated with both positive and negative influences;

  • excessive physical overload;

  • abrupt changes in weather or atmospheric pressure – affect only persons prone to meteorological dependence;

  • insufficient sleep – an adult must have a night’s rest of at least 8 hours;

  • alcohol abuse;

  • smoking, including passive smoking;

  • unhealthy diet, in which the body does not receive enough calories or vitamins and minerals;

  • premenstrual syndrome in women;

  • Stay in stuffiness for a long time.

In some cases, the onset of an attack of vestibular migraine occurs for no apparent reason. This phenomenon most often occurs early in the morning when you wake up or in the evening closer to bedtime.

First aid for an attack

At the time of the attack, the patient loses orientation in space, which is why he needs to take a horizontal position. While standing, the likelihood of falling and being seriously injured is greatly increased.It is also important to provide the person with peace and quiet. Migraine of a vestibular nature, like a classic one, causes an increased reaction of the body to sounds, light and smells.

You should not make sharp turns of the head, as they greatly increase the likelihood of an aggravation of the condition and the appearance of acute nausea, up to vomiting. The victim should be given the medication they are taking to control the attack. They should be washed down with clean water in the amount indicated in the annotation to the medicinal product.


The main criteria that are taken into account when making a diagnosis is the collection of anamnesis and patient complaints. In most cases, additional examinations are not required. At the same time, other diseases may be suspected in some patients, and in such a situation, an examination is necessary. Sometimes the symptoms of vestibular migraine can be similar to the manifestations of malignant tumors, abscess or cerebral edema, which are excluded with the help of MRI of the head.Sometimes it is required to find out whether there are violations of the vestibular apparatus or not, for which electronystagmography is performed.


To reduce the likelihood of attacks of vestibular migraine, preventive measures are required. The main ones are:

  • prevention of inhalation of strong odors;

  • ensuring adequate rest and sleep;

  • exclusion from food of foods containing a large amount of chemical additives;

  • elimination of factors that require prolonged eye strain.

Living the right lifestyle also greatly reduces the likelihood of a problem arising.

90,000 【Severity in the head, dizziness and headaches】 in Moscow

Headache and dizziness – one of the most common problems that plague modern man. The appearance of these symptoms can often be preceded by a disease of the cervical spine. Pain caused by a degenerative disease of the spine is called vertebrogenic.

As a rule, pain occurs in the back of the neck. In this case, vertebrogenic pain is characterized by the spread of pain outside the affected area: into the occipital region, arms, shoulders, up to the hands and fingers.


Pain of a vertebral nature, as a rule, can be both pulling and aching, and acute, shooting. In addition to pain, the following are also observed:

  • nausea, dizziness;

  • heaviness in the head, tinnitus;

  • darkening in the eyes, “flies”;

  • limiting the range of motion of the neck.

If you find these symptoms, you should immediately consult a doctor.


The purpose of diagnosing vertebral pain is to identify diseases of the spine: hernias, protrusions, osteochondrosis, anomalies in the development of bone and muscle tissues of the vertebral segments. For this, a number of instrumental diagnostic techniques are used:

  • X-ray examination of the upper spine;

  • ultrasound dopplerography of the cervical vessels during head turns;

  • computed and magnetic resonance imaging of the neck and brain.


Headaches, tinnitus, dizziness of vertebral etiology require the use of modern methods of therapy:

Method of therapy



Stimulation of the transmission of nerve impulses, improvement of microcirculation and tissue metabolism


Improves metabolism, increases the stability of the vertebral segments, passively strengthens the neck muscles

Exercise therapy

Actively strengthens the muscular corset of the neck and shoulder girdle

Many “cure”.


The cost of therapy is individual, depending on the methods used. The treatment plan is established following a consultation with a neurosurgeon.

Still have questions?
Our administrator can call you back.

Doctor cephalgologist – treatment of headache and dizziness

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  • Doctor cephalgologist

  • Portrait of a Competent Headache Specialist

  • Cephalgologist in Moscow

Headaches are a common problem of the modern population, which significantly reduces the quality of life. Often people prefer to ignore this nuisance, precisely on the basis that it “happens to everyone” and that you can always use pain relievers.Dizziness compared to headache is a more unusual and at the same time frightening condition, however, many decide to accept it.

Unfortunately, the lack of awareness of doctors of previous generations aggravates the situation with a similar attitude – due to the fact that such an independent discipline did not exist, scientific knowledge was not sufficiently accumulated, and attention was not paid to the individual aspects of human health. People simply did not know which doctor to go to with a headache.

There is no such problem in modern medicine. However, the name of a headache specialist is still not widely known. So which doctor treats headaches?

Physician cephalgologist

Cephalgology is a narrow branch of neurology that specializes in the study and treatment of headaches. A cephalgologist is not the one who prescribes “to drink analgin and drip droppers.” The modern approach is different. Not only medication, but also behavioral, psychological.

There are several types of dizziness, even more headaches. And even more – their possible causes and combinations in each unique human body. The cephalgologist possesses the techniques and knowledge of their detection and treatment.

Portrait of a competent headache specialist

A progressive cephalgologist at the reception with a patient is both a doctor and a detective, and even a philologist, because a headache is described in dozens of different formulations, and each of them can be a key to unraveling the diagnosis.

A modern specialist is guided by the following principles:

  • follows international treatment criteria;
  • does not recognize the old approach: treatment of headaches with droppers 2 times a year, ignoring (“everyone has a headache”), uncontrolled relief with painkillers;
  • constantly studies, improves qualifications in the field of headaches and related specialties, exchanges valuable experience with colleagues, discusses and practices in difficult and extraordinary cases;
  • sets realistic goals: does not promise miraculous healing, directly speaks about what will be effective and what will not, and how long therapy may take;
  • approaches treatment individually: considers the patient’s lifestyle, history, genetics and psychological aspects.

The cephalgologist also educates the patient himself on reliable information about the disease. This is important because there are dozens of rumors and false theories overgrown with headaches. A doctor treating persistent headaches is able to explain:

  • why the cause of pain is not associated with blood vessels and osteochondrosis;
  • The role of antidepressants in the treatment of headache;
  • how to relieve an attack of pain correctly and much more.

Cephalgologist in Moscow

In the branch of ENT clinic No. 1 in Moscow-City, a cephalgologist, neurologist, otoneurologist, candidate of medical sciences and a researcher of the department of vestibulology and otoneurology of the NMITSO FMBA of Russia Overchenko Kira Vladimirovna are receiving.If you are looking for a doctor to consult for severe headaches, here you will meet an experienced, attentive and advanced specialist.

Make an appointment with our cephalgologist in Moscow by phone or in a personal doctor’s card.


If a headache bothers you for many months or years, then before you see a doctor, you should keep a headache diary developed by the world scientific community for the treatment of headaches for such cases. You can download it here.


Migraine – Symptoms and Treatment

This type of headache refers to pain in vascular diseases. When a patient has a migraine attack, there is a throbbing pain on one or both sides of the head. At the same time, other symptoms are observed:

  • nausea accompanied by vomiting;
  • a noise is heard in the ears;
  • Increased sensitivity to light, smell and sound.

Treatment of migraine, the attack of which lasts no more than 72 hours, is carried out in an outpatient clinic.The most effective treatment is the use of drugs such as serotonin antagonists. If the attacks of the disease last more than this time, the patient is treated in a hospital.

With frequent manifestations of migraine, doctors offer a course of therapy to prevent the disease. If a patient has headache attacks more than 8 times a month, then it turns into a chronic disease.

Pains of increased intracranial pressure

Headache from high blood pressure is a dangerous type of disease.In this condition, a dull pain is felt inside the head, which gradually increases. The pain syndrome may not go away within 24 hours, although the intensity may fluctuate. Headaches can cause nausea and even vomiting.

A patient who has such symptoms must consult a doctor. Most likely, he will need examination and treatment at a hospital. Also, the patient receives advice from a neurosurgeon. Treatment is prescribed depending on what caused the high blood pressure.


Symptoms and treatment

This type of pain can be identified by its particular intensity. The patient suffers from unbearable pain, which is given off by a burning sensation and a pounding in the head. It moves along the path of the diseased nerve. At the same time, it is difficult for the patient to move, talk and eat.

Neuralgia treatment is under the supervision of a neurologist. To relieve pain, a therapeutic procedure such as blockade is sometimes used. Also, the doctor prescribes drugs with an anticonvulsant effect for treatment.

For headaches, diagnostics is carried out with the inclusion of such items.

  • The doctor specifies the characteristics of pain, its progress, periods of manifestation, as well as the appearance of any other signs.
  • General and neurological examination. The patient’s blood pressure is measured, blood and urine samples are taken for a general analysis. A biochemical blood test is prescribed, and also, reflexes are studied.
  • The patient is undergoing additional examination methods. Among them, the check of intraocular pressure, visual sensitivity, examination of the fundus, electroencephalography.

Advantages of headache treatment in the MC “Harmony KR”

The center employs neurologists who constantly attend refresher courses and learn the latest treatment methods.