Vestibular Migraines: Causes, Symptoms, Treatments

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on December 13, 2022

• What Is Vestibular Migraine?
• Vestibular Migraine Symptoms
• Vestibular Migraine Causes
• Who Gets Vestibular Migraines?
• How Are Vestibular Migraines Diagnosed?
• How Does My Doctor Rule Out Something Else?
• Vestibular Migraine Treatment
• Vestibular Migraine Diet
• More

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

The main symptoms are headache and dizziness that come and go – though you may not have a headache. “Vestibular” refers to the inner ear, which controls your hearing and balance. Vertigo refers to problems in the inner ear that might cause:  

• 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
• A feeling of disorientation or confusion
• An unsteady feeling, 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.

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.

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.

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 five 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 and 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)

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 may also 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 emergency help right away.

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 make the headaches less severe or less frequent. 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:
  • Beta-blockers: atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Hemangeol, Inderal LA, Inderal XL, and InnoPran XL)
  • Calcium channel blockers: verapamil (Isoptin)
• 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)

It’s possible to get relief by using 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 that 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 that 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.

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 food. 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.

Top Picks

Vestibular Migraines: Causes, Symptoms, Treatments

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on December 13, 2022

• What Is Vestibular Migraine?
• Vestibular Migraine Symptoms
• Vestibular Migraine Causes
• Who Gets Vestibular Migraines?
• How Are Vestibular Migraines Diagnosed?
• How Does My Doctor Rule Out Something Else?
• Vestibular Migraine Treatment
• Vestibular Migraine Diet
• More

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

The main symptoms are headache and dizziness that come and go – though you may not have a headache. “Vestibular” refers to the inner ear, which controls your hearing and balance. Vertigo refers to problems in the inner ear that might cause:  

• 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
• A feeling of disorientation or confusion
• An unsteady feeling, 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.

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.

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.

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 five 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 and 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)

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 may also 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 emergency help right away.

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 make the headaches less severe or less frequent. 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:
  • Beta-blockers: atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Hemangeol, Inderal LA, Inderal XL, and InnoPran XL)
  • Calcium channel blockers: verapamil (Isoptin)
• 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)

It’s possible to get relief by using 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 that 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 that 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.

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 food. 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.

Top Picks

MIGRAINE AND VERTIGO | #01-02/02

What is the basis of migraine aura?

What is a headless migraine?
What is meant by the term “linear migraine”?

According to epidemiological studies, from 5 to 16% of the population of developed countries suffer from migraine. The most common disease occurs in women aged 35-40 years [2, 9, 10]. Characteristically, the degree of its prevalence among the adult population of Europe and America tends to increase [10]. Over the past decade, ideas about migraine have undergone significant changes, due to the rapid growth of scientific research in the field of genetics, pathogenesis and treatment of this disease. Despite the complexity of the pathogenesis of the disease, most physicians recognize that the vessels of the brain become the main victim during a migraine attack. The vascular theory proposed back in the late 1930s by Wolff [15] considers migraine as a suddenly developing generalized “breakdown” of vasomotor regulation, which is manifested by the lability of the tone of the cerebral and peripheral vessels. From this position, aura in migraine is due to local spasm of cerebral vessels and the development of cerebral ischemia with the appearance of a variety of focal neurological symptoms (scotomas, hemianopsia, hemihypersthesia, dizziness, etc. ). A headache attack is a consequence of excessive vasodilation of intracranial and extracranial cerebral vessels, and periodic stretching of the vascular wall leads to the activation of pain receptors and gives the headache a pulsating character.

Almost 70% of migraine patients complain of dizziness of a different nature, which occurs both during a migraine attack and in the interictal period of the disease, and 50% have symptoms of labyrinth suffering and disturbances in vestibular tests [1, 7, 12]. The cochleovestibular symptoms are most pronounced in the basilar form of migraine, which occurs mainly in adolescents and young women. In most cases, a headache attack is preceded by systemic dizziness, ataxia, nystagmus, and tinnitus, which can last from several minutes to an hour. In severe attacks, bilateral blindness, alternating hemiparesis or tetraparesis, oculomotor disorders, diplopia, and vomiting may develop. The peculiarity of basilar migraine is that the neurological symptoms of the aura can persist in the phase of headache, which suddenly occurs in the occipital region, is of the strongest pulsating nature and may be accompanied by a short-term loss of consciousness. It is believed that the basis of focal neurological symptoms of aura in basilar migraine is the deterioration of blood circulation in the basin of the vertebrobasilar arteries [2, 3, 7, 13, 14]. Severe variants of basilar migraine should be considered as a complicated form of migraine. Observation of such patients shows that with age, basilar migraine transforms into less severe forms of the disease [2, 3].

Vestibular disorders of a peripheral and central nature are observed not only in basilar, but also in vestibular, ophthalmic, hemiplegic, aphasic and other forms of migraine with aura. In addition, dizziness often occurs during migraine attacks without aura [5, 11, 12]. Of particular interest are cases of the so-called headless migraine, or according to the international classification of migraine aura without headache [6]. An attack of this form of migraine is characterized by the presence of local, most often visual and vestibular, disorders without the subsequent occurrence of a headache. Vertigo may be peripheral or central and accompanied by pyramidal and sensory symptoms. The diagnosis of this form of migraine is probabilistic and requires the exclusion of organic brain diseases that can manifest as vestibular and cochlear symptoms. Proper diagnosis of migraine aura without headache is aided by hereditary history, age, cyclic nature of attacks, occurrence of migraine headache, complete regression of symptoms after an attack, further transformation of decapitated migraine into one of the typical forms of migraine with or without aura, as well as the absence of changes in laboratory and instrumental examination.

In childhood, the clinical picture of migraine is quite specific and, along with typical attacks, can manifest itself in the form of so-called migraine equivalents, or, according to the modern classification of headaches, periodic syndromes of childhood, which may be precursors of migraine or associated with it [6]. The most common equivalent of migraine in children is recurrent benign paroxysmal vertigo. This syndrome is characterized by the occurrence of short-term bouts of imbalance, systemic dizziness, anxiety, spontaneous nystagmus, and vomiting against the background of complete health [1, 2]. Neurological examination and additional instrumental studies do not reveal pathological changes in the nervous system or labyrinth in children. With age, attacks acquire the typical features of migraine with headache.

In the interictal period of the disease, 50% of patients with migraine with aura and 46% of patients with migraine without aura have neurological and otological symptoms indicating the non-random nature of the combination of migraine and vestibular disorders. It has been established that benign paroxysmal dizziness, Meniere’s disease and vestibular dysfunctions, detected in the study of spontaneous and induced vestibular reactions, are significantly more common than in the control group [1, 5, 8, 12]. A number of authors express the opinion that there is a hereditary and pathogenetic relationship between Meniere’s syndrome, paroxysmal benign dizziness in children and adults, and migraine [5, 11, 12]. Babiyak V. I. with colleagues (1996) believe that Meniere’s disease can, with certain assumptions, be attributed to a particular case of migraine, namely, to “maze migraine” with the phenomena of its “glaucoma” [1].

Dizziness and ataxia are very common symptoms of an attack of the so-called cervical migraine (Barré-Lieu syndrome, posterior cervical sympathetic syndrome). For the first time M. J. Barre (1925) described the symptom complex of headache, visual, auditory and vestibular disorders in patients with osteochondrosis and spondylosis of the cervical spine [3, 7]. The similarity of the clinical picture of the posterior cervical sympathetic syndrome with migraine allowed V. Bartchi-Roshen to call it cervical migraine [3]. An attack of a cervical migraine can be triggered by a sharp turn of the head or a long-term tension in the muscles of the neck and neck. Dull arching, less often throbbing pains appear in the cervical-occipital region, and then spread to the entire half of the head and orbital region. When describing the nature of the spread of the headache, patients figuratively run their palms from the back of their heads to their foreheads, a gesture that Bartchi-Roshen likened to “taking off his helmet.” The side of the hemicranial irradiation of pain usually corresponds to the side of the cervico-occipital pain. Headache is accompanied by dizziness, noise and ringing in the ears, blurred vision, and sometimes fainting. The duration of an attack can range from 30 seconds to several hours. According to most authors, a cervical migraine attack occurs due to irritation of the sympathetic plexus of the vertebral artery by osteophytes of the uncovertebral joints in individuals with degenerative-dystrophic changes in the cervical spine [2, 3, 7]. In some cases, the pain syndrome is not pronounced, and the symptoms of circulatory disorders in the vertebrobasilar basin – cochleovestibular, visual and other focal symptoms – come to the fore. Diagnosis of cervical migraine is based on a thorough study of the headache profile, factors that provoke its occurrence, neurological examination data and additional X-ray diagnostic methods for examining the cervical spine and craniovertebral region. Differential diagnosis with true migraine in most cases is not difficult.

Treatment of vestibular disorders in patients with migraine is an integral part of the complex of therapeutic measures carried out for this disease, and can be carried out both during an attack and prophylactically during the interictal period of the disease. The main principles of migraine treatment are modification of the lifestyle of patients in order to eliminate the causes that provoke attacks of the disease, and drug therapy. It is assumed that the deterioration of labyrinthine and cerebral circulation is the main cause of the appearance of “peripheral” and “central” dizziness in migraine [1, 2, 3, 8, 12]. It is believed that if the drug is able to improve blood circulation in the basin of the vertebrobasilar arteries and their branches, without affecting the blood circulation in the basins of other vessels, then it can be used to treat dizziness and related disorders [5, 13, 14] . Today, antihistamines and anticholinergics, diuretics, tranquilizers, barbiturates, calcium channel blockers, tricyclic antidepressants are offered. This list can be expanded with b-blockers, anticonvulsants, angiotensin-converting enzyme inhibitors, D2 type dopamine receptor antagonists, phenothiazine derivatives, etc. [1, 4, 8, 13, 14]. Among them, it is difficult to name the drug of first choice for the treatment of dizziness, since their effectiveness in this pathology was discovered “accidentally”, in the course of clinical use, and the mechanisms of their vertigolytic action are unknown. Until now, there has been no complete understanding of what properties a drug suitable for the treatment of vertigo should have. Some clarity on this issue was brought by the studies of Takeda and his colleagues (1993) [13]. The results of their experimental work made it possible to take a fresh look at the processes of the pathogenesis of vertigo and showed the special role of histamine in the functioning of the vestibular pathways and the regulation of vascular tone in the vertebrobasilar basin. The important role of H1 and H3 histamine receptors in the neurogenic and vascular mechanisms of the vertigolytic action of a number of drugs has been elucidated [4, 13, 14]. It was found that the clinical effect of one of the most effective drugs for the treatment of vertigo, betagestin (Betaserc), is based on the selective improvement of regional blood circulation in the labyrinth and the basin of the basilar artery without a significant effect on systemic arterial pressure. The neuronal mechanism of action of betagestin is associated with the normalization of neurotransmission processes in the histaminergic neurons of the vestibular nuclei, which determine the central mechanisms of dizziness [4, 14].

Thus, the modern approach to the treatment of vestibular disorders in migraine involves the use of a complex of non-drug and pharmacological effects aimed both at stopping an already developed migraine attack and dizziness, and at their prevention. There is no doubt the need to include the most effective vertigolytic drugs in the treatment regimen for patients suffering from migraine and dizziness.

Literature

1. Babiyak V. I., Lantsov A. A., Bazarov V. G. Clinical vestibulology. St. Petersburg: Hippocrates, 1996. 336 p.
2. Wayne A. M., Kolosova O. A., Yakovlev N. A., Slyusar T. A. Migraine. M., 1995. 180 p.
3. Shtok V. N. Headache. Moscow: Medicine, 1987. 304 p.
4. Aanta E. Treatment of acute vestibular vertigo // Acta Otolaryngol (Stockh). 1991. Suppl 479. P. 44-47.
5. Cass S. P., Ankerstjerne K., Balaban C., Yetister S., Aydogan B. Migrainerelated vestibulopathy // Ann Otol Rhinol Laringol. 1997. No. 106 (3). P. 182-189.
6. Classification and Diagnostic Criteria for Headache Disorders, Cranial Neuralgias and Facial Pain, International Headache Society, Cephalalgia. Vol. 8. Suppl. 7. 1988.
7. Goadsby P. J. Pathophysiology of Migraine: A disease of the Brain // Headache / Goadsby P. J., Silberstein S. D. (eds). Butterworth-Heinemann. 1997. P. 5-25.
8. Gordon C. R., Kuritsky A., Doweck I., Spitzer O., Shupak A., Hering R. Verstibulo-ocular reflex in migraine patients: the effect of sodium valproate // Headache 1993. No. 33 (3). P. 29-32.
9. Rasmussen B. K. Epidemiology of migraine // Towards Migraine 2000 / F. Clifford Rose (ed.) Elsevier Science. 1996. P. 1-15.
10. Steward W. F., Lipton R. B. Migrain Epidemiology in the United States // Headache Classification and Epidemiology / J. Olesen, ed. New York: Raven Press, 1994. pp. 239-247.
11. Split W., Lukomski M. Evaluation of the vestibular system in patients with migraine // Neurol Neurochir Pol. 1988. No. 22 (5). P. 383-386.
12. Szirmai A. Vestibular disorders in patients with migraine // Eur Arch Otorhinolaryngol Suppl. 1997. No. 1. S. 55-7.
13. Takeda N., Morita M., Hesagawa S., Horii A., Kubo T., Matsunaga T. Neuropharmacology of motion sickness and emesis. Acta Otolaryngol (Stockh), 1993. Suppl 501, pp. 10-15.
14. Timmerman H. Pharmacotherapy of vertigo: any news to be expected? // Acta Otolaryngol (Stockh). 1994. Suppl 513. P. 28-32.
15. Wolff H. G. Headache and Other Pain. New York: Oxford University Press. 1963.

Can a migraine cause dizziness or disorientation?

Vestibular migraine or “dizziness associated with migraine” or “migraine with vertigo” is a disorder of the nervous system that causes dizziness or disorientation in people suffering from migraine symptoms. An attack of dizziness can last from a few seconds to several days, although such an attack rarely lasts more than 72 hours. Having lived with chronic migraines for over twenty years, Kira O’Rourke thought she knew all about the condition. But one day, a year ago, while having lunch with colleagues in the cafeteria, she experienced a migraine attack with dizziness. Today Kira talks about how migraine symptoms have changed over the years and how migraine with vertigo affects her daily life.

It’s no secret that my migraines have changed over the years.

When I was 20, the attacks were mostly episodic and happened shortly before my period. But as I got older and had children, my migraines changed and got worse.

The episodic attacks suddenly became more severe and lasted longer, and they began to affect my life much more.

Not only did my migraine symptoms change, I also developed chronic daily headaches. Chronic headaches are when you have more days each month with a headache than without one. In my case, I had up to 25 days with a headache out of 31. And it became the norm, something that I had to learn to live with and that I had to accept.

I have sought help and support from relevant services, including migraine specialists recommended by my doctor. I tried my best not to give up in front of a chronic migraine – you can say that I “did everything right.”

After 20 years of living like this, I honestly didn’t expect my migraine symptoms to change… and, of course, that’s exactly what happened.

New migraine symptom was dizziness

New symptoms appeared about a year ago. My colleagues and I had lunch in the canteen. And suddenly, for no reason at all, the room began to rotate.

I thought I was going to fall off my chair. I grabbed the table to keep from sliding to the floor and forced my mouth muscles to move to ask for help from my colleagues.

I was very frightened and could not understand what was going on. There was a feeling that the head was spinning, and the room did not want to remain motionless.

Two colleagues lifted me up, one from each side, and helped me to the office. I completely lost my balance and constantly fell to the side. Colleagues led me carefully into my darkened office (photophobia is one of my migraine triggers). I sat there for about 40 minutes until my husband called and said that he was waiting for me outside and ready to pick me up.

Colleagues helped me get to the car and my husband took me home. I went straight to bed.

Diagnosis: vestibular migraine

The next day I couldn’t help feeling that the new dizziness was directly related to chronic migraine.

I called my migraine nurse and asked if she could explain the new symptom. I could only say that I completely lost my orientation in space and it seemed to me that my head would never stop spinning.

My nurse very gently and patiently explained that it was a dizzy spell. She said that vestibular migraine occasionally occurs in people with chronic migraine and that symptoms can change over time.

I learned that the main symptom of vestibular migraine is dizziness, and an attack can occur even if there is no ordinary headache. I felt better when my condition was given a name, and I recognized many of the symptoms described, having experienced them the day before in the cafeteria.

• sensation of disorientation in space and balance
• sudden feeling of “sickness” when moving the head
• dizziness
• nausea

In the meantime, the nurse advised me to keep a migraine diary.

I have been keeping this diary for several months and, to be honest, I did not notice any regularity or reasons for the attacks.

They happened at any time of the day, whether I was at work or relaxing at home. I checked to see if it was related to my menstrual cycle, but no, it doesn’t seem to be a trigger either.

I contacted the nurse again and we discussed my diary. Vestibular migraine attacks occurred two to three times a month, and each time the dizziness lasted 5-10 minutes.

And even after the dizziness stopped, there were consequences. My head was cloudy, as if in a fog, and I struggled with dizziness and weakness. And the head continued to spin, although not nearly as much as in the first 5-10 minutes.

All this together gave after an attack a feeling of complete loss of coordination and lack of concentration. And yet, it was difficult for me to concentrate, that is, the seizures prevented me from working.

Try a new treatment

I talked to my nurse and she referred me to a physiotherapist who specializes in vestibular disorders.

As the nurse said, this physiotherapist usually works with patients who have problems with their eyes, nose, and throat. However, there were good results in patients with migraine, so it made sense to make an appointment.

I willingly agreed, and now I am waiting in line for the procedures. In the meantime, I’m trying to collect as much information as possible about this specialized physiotherapy. I can already see how much relief can be achieved in patients with vestibular migraine, so I can’t wait for treatment to begin. I’ll keep you posted on what’s happening!

Help with vestibular migraine and new symptoms

I finally realized that I would have to constantly learn something new about my condition.

20 years ago, when I was diagnosed with chronic migraine, I was so naive and did not think about the difficulties that I would have to cope with. And I still had to painfully realize how much all this would affect my daily life.