A migraine is a highly debilitating chronic ailment across the world. It is almost equally prevalent as high blood pressure or hypertension, diabetes, and asthma. Most of the individuals tend to develop migraine issues during most productive years of their lives, that is between 20 – 40 years.
Despite enhanced efforts to enhance public awareness and better diagnostic capabilities, it is believed that 50% of individuals suffering from a migraine go mismanaged and undiagnosed.
What is Vestibular Migraine?
Often deemed as ‘a sick headache’, this is a disorder characterized by severe progressive of head pain, the onset of pain in the head, pounding, throbbing, and interference with the routine activities of the person.
When there is repeated dizziness or vertigo in individuals accompanied with or without a headache, then this disorder is known as a vestibular migraine. This disorder is also known as Migrainous vertigo, Migraine-associated vertigo, and migraine-related vestibulopathy.
Vestibular Dysfunction and Migraine
Almost 40% of patients suffering from a migraine is accompanied by a vestibular syndrome that involves a disruption in their balance and dizziness. Such symptoms might be experienced prior, during, or even after the course of migraine event.
There are few interesting parallels existing between a migraine and non-migrainous vestibular disorder. Most of the environmental and food triggers for migraineurs are the same as to patients with non-migrainous vestibular dysfunction. Foods, hormonal fluctuations, and climatic changes often increase the severity of both conditions. Eventually, certain medications and diet modifications can help manage a migraine and the resulted vertigo. But one important aspect is that often such ways to manage the disorder fail to completely resolve a headache and vertigo problem.
Symptoms of Vestibular Migraine Resulting in Vertigo
A vestibular migraine correlating with vertigo may include, but is not limited to various symptoms, like
- Intolerance of motion with respect to head, eyes, or entire body
- Spontaneous Vertigo Attacks
- Vomiting and Nausea
- Reduced focus of the eye with photosensitivity
- Tinnitus and Sound Sensitivity
- Loss of balance and Ataxia
- Cervicalgia or Neck Pain associated with muscle spasms
- Spatial Disorientation
- Confusion accompanies with altered cognition
How a vestibular migraine Causes Vertigo?
Is most of the cases a migraine is deemed to be associated to benign recurrent vertigo or adults or the paroxysmal vertigo of childhood, but it is also possible that some vestibular migraine patients may also show symptoms of Benign Paroxysmal Positional Vertigo or BPPV even when the migraine event has ceased. This is considered to be mainly because of a combination of vascular events resulting in alteration of neural activity linked to the migraine event.
It is considered that such changes more commonly affect the superior part of the vestibular nerve or the utricle and anterior vestibular artery than the inferior part of the vestibular nerve and posterior vestibular artery. This explains that most of the results obtained within the normal range are often availed with the vestibular evoked myogenic potentials or VEMP testing of migraine patients when the true BPPV has not occurred.
The symptoms of a migraine can happen with pain and dizziness or can occur with dizziness and without pain. Individuals suffering from a migraine can experience vertigo at any point in time. Even vertigo resulted from a migraine can be accompanied with or without movement.
Such symptoms may last for a couple of seconds or few days. The attacks often occur in groups, instigating and stopping for a specific period of time.
Vertigo occurring from a vestibular migraine is a very common disorder. Once vision changes, vertigo is one of the most frequently reported symptoms particularly with those experiencing ‘a migraine with aura.’
An understanding migraine with Aura Resulting in Vertigo
A migraine with aura, also known as a classic migraine is accompanied by aura features and headache. The characteristics of the aura are similar to those for a migraine with aura features. The common characteristics of a migraine with aura are:
- One reversible symptom of aura indicating CNS or focal central nervous system dysfunction that is tinnitus, vertigo, ataxia, dysarthria, reduced hearing, paresthesias, double vision, reduced levels of consciousness, and paresis.
- Symptom of aura developing gradually over more than 2 minutes
- A headache occurring during, before, or after 60 minutes of the aura
If the aura characteristics continue to occur with a migraine, then 2 or more symptoms can be experienced, such as:
- Visual Symptoms in Hemifields of Both Eyes
- Double Vision
- Bilateral Paresthesias
- Bilateral Paresis
- Reduced levels of Consciousness
- Visual disturbances in both hemifields of both eyes
If you are experiencing severe vertigo, then it can result in difficulty in walking or standing. Even it can lead to nausea. If the problem still persists then it can result in another symptom of light sensitivity, also known as photophobia.