Demystifying Dizziness- Vestibular Migraine

Almost everyone knows someone who has experienced a migraine headache. Most people associate it with a severe, throbbing type of head pain that causes the need to lay down in a dark room. While migraines are a relatively common neurological disorder, what many people do not realize is that they can present in many different ways.

A vestibular migraine is a type of migraine that is strongly associated with symptoms of vertigo (spinning sensation), motion sensitivity, and trouble with balance and coordination (remember that the term vestibular refers to our balance system). What can make diagnosing a vestibular migraine challenging is that these symptoms may occur with or without an actual headache. So, you may be thinking to yourself, why is it called a migraine then? Let’s dig a little deeper into this.

What is a Migraine?

While a headache is the most common symptom of a migraine, the reality is that not everyone who gets migraines will actually experience a headache. Some people will predominantly experience what are sometimes called aura symptoms, such as flashing lights, ringing in the ears, or dizziness, but never proceed to develop the throbbing head pain. In the case of vestibular migraines, the predominant factor is vertigo and motion sensitivity. Often, there is also a history of having had migraine headaches, though the headache pain may not necessarily be present during an episode of a vestibular migraine.

Common migraine headaches and vestibular migraines share many factors including:

· Both tend to run in families

· Both tend to affect females more than males

· Both have common triggers- such as rapid changes in weather, stress, hormonal influences, poor sleep, and certain types of foods

In a vestibular migraine, the vertigo and motion sensitivity can often last a few hours to a day. In addition, a person may also experience feelings of fullness and/or ringing in the ears, though this should be differentiated from other inner ear disorders.

So, what causes it?

While the exact pathology of a vestibular migraine is unknown, it is thought that changes in neurotransmitters and hormone levels, such as serotonin and estrogen, can trigger blood vessels in the brain to contract. This in turn will affect the activity of the surrounding nerve cells and may trigger the symptoms associated with migraines. When this occurs near structures associated with your vestibular system symptoms of dizziness, nausea, and imbalance may result,

In addition, biomechanical disturbances in the neck may also play a role in the onset of both headaches and dizziness. The upper neck acts as a bottle cap that allows all the fluid from your head to drain into the rest of your body. Injury to the upper neck can slow this drainage, resulting in a build-up of fluid containing cellular waste in the head. This can create a toxic environment around the nervous system which is thought to make it more sensitive to environmental changes, which can trigger the cascade of events leading to a migraine.

For more information on this, check out my previous article Dizziness and Headaches- What’s the ConNECKion?

What should you do about it?

The first step in managing migraines, including vestibular migraines, is knowing what your triggers are. Keeping a journal of when you experienced symptoms and what happened before they started is a good place to start. Once you have a clear idea as to what your triggers are, making some lifestyle adaptations to avoid these is the next step. This may include dietary changes, developing a stress management strategy, or enhancing your sleep hygiene.

Many people will work with their family doctor to help manage medications for their migraines. Additionally, addressing other factors, such as postural and structural imbalances, that can also contribute to headaches is important when search for a solution to this problem. Working with practitioners who specialize in head and neck injuries may be beneficial in assessing these biomechanical factors influencing migraine symptoms (ex: upper cervical chiropractors). Other types of practitioners who can aid in addressing nutritional factors and vestibular compensation include naturopaths, nutritionists, and functional medicine doctors.

Demystifying Dizziness Summary

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Dr. Speranza is an upper cervical Chiropractor in Calgary, Alberta, Canada. She follows the protocols of the National Upper Cervical Chiropractic Association (NUCCA) to help people experiencing problems with postural related dizziness regain balance, return to doing the activities that they love, and ultimately take back control of their health.