Vestibular Migraine: Symptoms, Causes, and Management

Migraines are often associated with severe headaches, nausea, and sensitivity to light and sound. But for some people, migraines take a slightly different form - one that affects balance, motion, and the inner ear. This is called a vestibular migraine, sometimes referred to as migraine-associated vertigo. While it’s less widely recognised than classic migraines, it can be just as disruptive to daily life.

Vestibular migraine is a type of migraine that primarily affects the vestibular system, which is the network in the inner ear and brain responsible for balance and spatial orientation. People with vestibular migraines may experience vertigo (a spinning sensation), dizziness, unsteady gait, or a feeling of motion even when standing still. Interestingly, the headache itself may be mild or even absent in some cases, which often leads to delayed or misdiagnosis.

Vestibular migraine symptoms can vary in intensity and duration, and they often overlap with other conditions such as inner ear disorders. Typical symptoms include:

• Vertigo or spinning sensation (lasting minutes to hours, sometimes days)

• Lightheadedness or feeling off-balance

• Nausea or vomiting

• Sensitivity to motion or visual stimuli

• Classic migraine symptoms such as headache, sensitivity to light/noise, or visual auras (though these may be absent)

Symptoms may be triggered by the same factors that cause regular migraines, including stress, hormonal changes, certain foods, sleep disruption, or sensory overload.

1. Hormonal fluctuations: Sudden estrogen drops around periods can heighten sensitivity in the brain’s balance and pain pathways.

2. Genetic predisposition: A family history of migraine increases individual susceptibility to vestibular episodes.

3. Sensory overload: Bright lights, crowded visuals, loud spaces, or fast-moving screens can overwhelm the vestibular system.

4. Inner-ear sensitivity: Temporary glitches in how the brain interprets balance signals from the inner ear can trigger episodes.

5. Stress & sleep imbalance: Irregular sleep, high stress, and cortisol spikes can destabilise the brain’s migraine threshold.

6. Dietary triggers: Caffeine swings, aged cheese, processed meats, and artificial sweeteners can set off vestibular symptoms.

7. Weather changes: Sudden shifts in humidity or barometric pressure can alter brain sensitivity and trigger attacks.

   

Diagnosing vestibular migraine can be challenging because the dizziness and vertigo symptoms mimic other conditions such as benign paroxysmal positional vertigo (BPPV), Ménière’s disease, or vestibular neuritis. Doctors usually rely on:

• Detailed medical history and symptom patterns

• Neurological and vestibular examinations

• Exclusion of other inner ear or neurological disorders

• Imaging tests (like MRI), if necessary

There is no single test that confirms vestibular migraine, making awareness of symptom patterns critical.

Management of vestibular migraine focuses on stabilising daily rhythms and reducing triggers that overwhelm the brain’s balance pathways. Simple adjustments like consistent sleep, stress reduction, steady meals, good hydration, and avoiding sensory overload (bright lights, loud spaces, fast screens) can significantly reduce episodes.

Tracking symptoms, foods, hormonal shifts, and weather patterns helps pinpoint personal triggers and avoid flare-ups before they begin. Vestibular rehabilitation therapy, customised exercises can retrain balance signals and reduce motion sensitivity over time.

In addition, cannabinoid-based medications may help stabilise sensory processing, reduce dizziness, and calm the neurological overactivity linked to migraine episodes, offering a natural alternative for long-term support.

Seek urgent medical care if dizziness is paired with a sudden, severe headache, vision problems, weakness, numbness, or speech changes.

Vestibular migraine is a complex but manageable condition. Understanding the symptoms, recognising triggers, and working with healthcare providers for proper diagnosis and treatment can help sufferers regain balance. Awareness is key, because while it may not always involve a pounding headache, its impact on daily life can be just as profound.

Also Read:

• What is Migraine?

• Types of Migraine?

• Understand Migraine Symptoms and Causes for Better Prevention

  Medically Reviewed by - Dr. Bhanu, Ayurvedic Physician