Vestibular migraine is a neurological disorder that is considered a type of migraine and is associated with dizziness (vertigo). While migraine and vertigo refer to two separate conditions that are often associated with each other, vestibular migraine describes a clinical picture in which both symptoms occur together. This is a less well-known form of migraine, which is usually characterized by dizziness, imbalance, headache and sometimes other migraine symptoms at the same time.
Relationship between Migraine and Vertigo
Migraine is a condition that is usually recognized by classic symptoms such as headache, sensitivity to light and sound, and nausea. However, migraine can also have effects on the vestibular system. The vestibular system is a balance system and regulates the relationship between the semicircular canals in the inner ear and the brain. Migraine can have an effect on this system, causing dizziness (vertigo) and a feeling of imbalance. In the case of vestibular migraine, migraine attacks are accompanied by dizziness and balance problems.
Triggers of Vestibular Migraine
Vestibular migraine can have the same triggers as those that usually trigger migraines. These include stress, changes in sleep patterns, certain foods (e.g. chocolate, cheese, alcohol), weather changes, bright lights and noise. However, vestibular migraine can also have a unique trigger, for example, prolonged head movements, traveling in a car or on a boat can also trigger dizziness attacks.
Symptoms of Vestibular Migraine
The most distinctive feature of vestibular migraine is that dizziness is experienced in parallel with migraine headaches. However, vestibular migraine without headache is also possible. Other common symptoms include:
- Dizziness (Vertigo): Dizziness can usually last from a few minutes to several hours. Dizziness attacks are sometimes characterized by a feeling of spinning, sometimes by loss of balance and dizziness.
- Unsteadiness: The person may find it difficult to stand even in an environment where they normally feel balanced.
- Nausea Nausea is usually accompanied by dizziness.
- Light and Sound Sensitivity: Light and sound sensitivity, which are among the classic symptoms of migraine, may also be part of vestibular migraine.
- Headache Some vestibular migraine patients may also have classic migraine headaches, although not all cases are associated with headaches.
How Migraine Triggers Vertigo
Migraine is caused by certain chemical changes in the brain, especially dysregulation of neurotransmitters such as serotonin and dopamine. These chemical imbalances can affect the pain centers in the brain as well as the vestibular system, which provides balance. During migraine attacks, improper transmission of signals between the brain and the inner ear can lead to symptoms such as dizziness and imbalance.
The effect of migraine on the vestibular system is linked to incorrect stimulation of the semicircular canals and vestibular nerves, especially in the inner ear. The incorrect transmission of these signals sends a sensation of “spinning” or “imbalance” to the brain. At the same time, mismatches between the brain and eye muscles during migraine can also lead to visual and balance-related disorders.
Diagnosis and Treatment of Vestibular Migraine
The diagnosis of vestibular migraine is sometimes difficult to differentiate from other balance disorders. When making the diagnosis, the frequency and duration of dizziness and whether it is related to migraine are questioned. The diagnosis is usually based on clinical examination and the patient’s history. In addition, tests that examine balance and brain imaging methods (MRI or CT) may be used.
Treatment focuses on managing both migraine and vertigo. Treatment options may include:
- Medications: Painkillers, triptans, antiemetics, antiemetics and drugs that reduce the effects on the vestibular system can be used to treat migraine. Beta blockers, antiepileptic drugs or antidepressants may also be recommended for migraine prevention.
- Lifestyle Changes: Paying attention to sleep patterns, avoiding trigger factors (e.g. stress management, proper nutrition) can reduce the frequency of migraine.
- Physical Therapy: Vestibular rehabilitation therapy can help reduce dizziness and imbalance. This therapy includes exercises that improve balance and stimulate the vestibular system.
Conclusion
Vestibular migraine is a complex neurological disorder that combines dizziness and migraine. The effects of migraine on the vestibular system lead to symptoms such as vertigo and imbalance. This, together with the classic symptoms of migraine, can seriously affect the quality of life of patients. With the right diagnosis and treatment, vestibular migraine can be managed, but treatment of this disease may require a multidisciplinary approach.
