What is a vestibular migraine?
vestibular migraine is a nervous system problem that causes repeated dizziness (or vertigo) in people who have a history of migraine symptoms. Unlike traditional migraines, you may not always have a headache.
“The vestibular symptoms are quite variable,” Doctors says. “They could include a spinning feeling, a sensation of movement and the perception that things are moving out of proportion to the environment.”

There are many names for this type of problem, Your doctor might also call it, Migraine-associated vertigo.
Migrainous vertigo.
Migraine-related vestibulopathy.
How do vestibular migraines differ from classic migraines?
A migraine headache causes moderate to severe pain and tends to recur. The pain often begins on one side of the head and throbs or pulses. You may notice sensitivity to light, sound and odors. You may experience nausea and vomiting.
Some people notice a warning signal or aura (visual cues such as bright flashing lights, for example) before a migraine.
They tend to run in families, but there are other triggers — emotional stress, sensitivity to chemicals and preservatives in food, caffeine, and sleep deprivation.
Vestibular migraines mirror many of these symptoms along with dizziness (with or without a headache).
Doctors say, they look for the absence of signs of an inner ear problem or other possible sources of dizziness to help make a diagnosis.


What Are the Symptoms?
Vestibular migraines don’t always cause headaches. The main symptom is dizziness that comes and goes. Vestibular refers to the inner ear, which controls your hearing and balance. If you’re having a vestibular migraine, you may feel: Dizziness that lasts more than a few minutes.
Nausea and vomiting.
Balance problems.
Extreme motion sensitivity -- feeling sick or dizzy when you move your head, eyes, or body.
Feeling disoriented or confused.
Feeling unsteady, like you’re in a rocking boat.
Sensitivity to sound.
You could get dizzy and have balance problems without having a migraine at all.
Other times, the vertigo symptoms happen before, during, or after the headache. Sometimes, you might have migraines for years before the vertigo symptoms begin.

What Causes Them?
Doctors aren't sure. Like migraines, there are a lot of theories. But how it really happens is poorly understood. They credit it to misfires between nerve cells in your brain.
Who Gets Them?
It's hard to tell how many people are living with this condition. The symptoms mimic a lot of other diseases. Researchers think they affect about 1% of the population. But that number could be higher.

Like traditional migraines, they’re more common in women than men. Vertigo symptoms tend to first strike around age 40. But the condition doesn't just affect adults. Kids can get it, too.
How do doctors treat vestibular migraines?
“Typically, we treat migraines and vestibular migraines the same,” Doctors says.
They suggest three common approaches: Determine and avoid your triggers — stress, certain foods or not enough sleep.
Take supplements, such as riboflavin or magnesium.
Take over-the-counter or prescription drugs to reduce pain or prevent headaches.

How does Physical Therapy Help vestibular migraine?
Your doctor also may prescribe vestibular rehabilitation, a type of physical therapy that can help improve balance and manage your dizziness.
The rehabilitation team will tailor an exercise plan for your specific problems, including exercises for neck stretching and vision stability.
After migraine attacks are better controlled, a physical therapist specializing in vestibular treatment may help improve unsteadiness. Therapists use exercises designed to increase balance control.
The goal of therapy is to become less sensitive to activities that provoke dizziness, nausea, or unsteadiness.
The therapist will evaluate the patient and design a specific program of exercises to increase tolerance to movement and situations that are uncomfortable.
Exercises are progressed so that at the end of treatment the patient is able to tolerate normal or near normal amounts of light, sounds, and activity around them.
The therapist will also test balance and teach exercises to help the person improve their sense of steadiness in their home and community.

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