Vestibular Migraine | Symptoms. Diagnosis and Treatment

Vestibular Migraine

Symptoms, Diagnosis, and Treatment of a Vestibular Migraine

A vestibular migraine is known by various names such as migraine of vertigo, migraine-associated vertigo, migrainous vertigo, and migraine-related vestibulopathy. It results from disorderliness in the nervous system, and often it is the cause of perpetual dizziness and vertigo. Although, it may not come with a traditional headache which is associated with other types of migraines.

The major cause of a vestibular migraine is clearly unknown. Various theories have been proposed by many physicians, but all have agreed that the root of a vestibular migraine is related to dysfunction of the inner ear, blood vessels and the nerves. A vestibular system and the inner ear are controlling balance in man. Vertigo occurs due to disturbance of this system, which causes dizziness and unsteadiness in movement. A vestibular migraine is more common in females than males, still, various studies reported cases in children. Yet, it is still believed to be more prevalent among adults. Doctors have observed that specific aura occur when there is a damage in a vestibular system. In this case, an aura may last for hours before it decreases.


Severe pain in the ears and neck are a major trait of a vestibular migraine. Also, there is visual discomfort as a result of this type of migraine. It often distorts coordination and balances, which gives the notion that the ground is turning, making a falling sensation. Also, it distorts both hearing and visual senses. The common noticeable symptoms of a vestibular migraines include vertigo, loss of coordination and balances, dizziness. However, other relevant symptoms are:

  • Pain in the neck;
  • Severe discomfort during turning and bending;
  • There is also a sensation of severe pressure in the ear and head;
  • Tinnitus does occur;
  • Vision impairment.
Vestibular Migraine symptom - pain in the neck

Most of the time the severity of these symptoms varies. They occur without a headache, but the probability of having head pains along these symptoms is also there.


Early diagnosis of a vestibular migraines is very important and should be done by a neurologist or other specialist who has deep knowledge of the nervous system. Cross-examination of the medical records of the patient is very important, test such as MRI and CT test is also crucial for appropriate diagnosis.

The diagnosing guidelines as given by International Headache Society (HIS) are:

  • Migraine History;
  • Any of the vestibular symptoms that occur more than 5 minutes;
  • Half of the episode occurs with migraine headaches, and problems with sight;
  • At least five episodes are only a vestibular symptoms, or along with a migraine.


Most prescribed medications are to stop the attack when it occurs, and such drugs are often described as abortive therapy. That include:

  • A vestibular suppressant, which helps balance in the center of the inner ear.
  • Analgesic
  • Antiseizure

Constantly having a healthy sleep pattern is very helpful in treating a vestibular migraines, triggers due to hormone secretions or changes in stress level which may be unavoided are best combated with drugs and medical support. Preventive measures, such as changes in lifestyle, eliminating allergies or triggers can all help in minimizing a vestibular migraines.