Vestibular Migraine Not As Rare As Once Thought
Vestibular Migraine was once considered rare, but it is increasingly becoming a more widely recognized diagnosis. This type of Migraine is characterized by vertigo and dizziness. It is a common cause of headache with dizziness, but VM can occur with or without head pain.
Migraine-associated vertigo affects between 1-3% of the general population, making Migraine the leading causes of vertigo and dizziness in adults
Only about half of all patients with VM experience pain with their attacks. It can be confusing to get a diagnosis of Migraine if you have no pain, but an accurate diagnosis is key to finding the right treatment and relief.
How Are Vestibular Migraines Diagnosed
Thereâs no blood or imaging test that can tell for sure. But the International Headache Society and other organizations recently set up the first criteria to help your doctor diagnose the disorder.
You could be having a vestibular migraine if:
- You have migraines or had them in the past.
- You have at least 5 episodes of vertigo that make you feel like you are spinning or moving. This isnât the same as motion sickness or feeling faint.
- These feelings last between 5 minutes to 72 hours.
- Your symptoms are moderate to severe. That means they stop you from doing everyday tasks or theyâre so bad you can’t do anything at all.
- At least half of the episodes happen with one of the following migraine symptoms:
- A headache that has two of these characteristics: is one-sided, pulsing, moderate to severe, or gets worse with activity
- Sensitivity to light or sound
- Seeing shimmering or flashing lights in your vision
Current And Emerging Treatments
Patients who suffer from recurrent migraine episodes may need to be provided with a treatment strategy that includes preventative care as well as a plan for abortive therapy. Neurologists generally use the same 2-pronged approach when taking care of patients who experience recurrent vestibular migraines. When patients have frequent, unpredictable, or disabling symptoms, prevention is certainly an important consideration.
Prevention remains key, and I find antiepileptic drugs or venlafaxine to be most effective, Watson said. If the vestibular symptoms are part of migraine, the prognosis is pretty good. However, not all preventative medications are accessible for each patient, and some treatments that are FDA-approved for migraine prophylaxis are not approved for vestibular migraine, making payer authorization for off-label use in vestibular migraine another impediment.
I generally treat patients who have vestibular migraine prophylactically just like I do regular migraine patients, and it depends what their insurance will approve. Options for prophylaxis include amitriptyline, propranolol, and topiramate. My preferencebut often not approved up-front by insurancewould be 1 of the 3 anticalcitonin gene-related peptide injectables: erenumab , fremanezumab , or galcanezumab , Rebovich said. Other treatments used for prevention of vestibular migraine include flunarizine and cinnarizine, AEDs , beta blockers , antidepressants , and magnesium and clonazepam.4
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Snris For Vestibular Migraine
Dr. Michael Teixido’s inaugural talk on Vestibular Migraine at the 2019 Migraine World Summit included his positive experience using SNRIs to treat patients with Vestibular Migraine
Recent studies have shown they are an effective and safe treatment, particularly for those who also have anxiety that accompanies their Migraine attacks.
Anxiety is a common trait of Vestibular Migraine attacks, which makes sense considering how frightening some of the symptoms can be.
A meta-analysis of 6 controlled trials testing 418 patients revealed that those taking SNRIs had fewer Migraine days than those taking placebo
Further Information About Vestibular Migraine
Please contact us;for further information about vestibular migraine or to chat with a member of our team. Further information about vestibular migraine is also available at vestibularmigraine.co.uk .
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Articles On Migraine Types
There are many names for this type of problem. Your doctor might also call it:
- Migraine-associated vertigo
How I Got Better
Accepting it!Here is a video on how I had to learn to accept it and stop FIGHTING it all the time as it was so exhausting!;
Vestibular exercises Here are thevestibular exercises I did. Luckily living in London put a massive strain on my vestibular system meaning I actually think I got better FASTER! I also did a few weeks of vestibular exercises and here are some of the basic ones I did although I do not need to do them anymore.;
Physiotherapy ;I started to have regular Physiotherapy on my neck. After a past severe whiplash injury which I thought added to my symptoms, I used to go for a weekly massage for around a month, and then every 3 weeks. I found that my neck was less sensitive and I had fewer migraines too.
Counselling My biggest regret was not seeing someone sooner, and I tried to manage it all on my own. I felt my partner although incredible loving & supportive just couldnt handle this all the time and working 10 hour days & also providing for a very sick partner who was depressed and down every day. Here is how I felt on dealing with the depression that goes with it.;
Computer Glasses! I still had to work but I could only manage 2 hours a day working from home as a social media manager. I found the screen made my symptoms worse and I felt exhausted but when you need money, not a lot of options there, you just have to do it! I bought computer glasses that helped get rid of glare. Here are some other vital things that helped me vitamin wise.
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An October Night Ill Never Forget
All of this began in October 2016. A night at home watching a scary movie with my husband, turned into a horror well beyond the two-hour rental.; What felt like a panic attack would soon reveal itself as a condition called Vestibular Migraines. A sensation came over me where I felt as if I was sinking into my couch as the room started to spin. My heart began to race, my face became numb, and I lost all control of my balance. Like any sane person, I thought I was having a stroke or a heart attack until I used my rationale to realize Im a healthy 27-year-old, it had to be something else.
A few weeks went by where I felt as if I had been drinking wine to the point where I couldnt drive. I was helpless. After months of appointments with several different doctors, I was led to believe I had a Sinus Infection, Benign Paroxysmal Positional Vertigo, Multiple Sclerosis and Superior Semicircular Canal Dehiscence . I underwent two CT scans, an MRI, and a full-fledged ear examination hearing test, vision test, sound check, the works. When those tests came back negative for anything cancerous, my ENT introduced me to a condition they believed I had called Vestibular Migraines.
While it was a relief to put a name to my dizzy spells finally, it was a struggle for me to understand how you treat a migraine thats not an actual headache.; No Advil, Excedrin, Triptans and pain meds dont work.
Cut Out These 2 Foods
The two most commonly problematic foods, that often dont even come with any gut or digestive issues if you have problems with them is:
Dairy is a massive source of congestion. If we cannot digest dairy properly, we are loading our body and immune system up. This can create a lot of mucus.
This mucus will clog our ear nose and throat system and that is where many vestibular issues may start.
Gluten has been implicated in so many different neurological diseases its incredible.
If you are having any chronic issues, especially migraines, cut the gluten.
There is also a term called gluten-induced ataxia where the eating of gluten you are sensitive to creates degeneration in the brain and can lead to balance issues, slurred speech etc.
Avoiding these two may be one of the best decisions you ever make.
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Tricyclic Antidepressants For Vestibular Migraine
Another popular class of medication used to treat Vestibular Migraine is tricyclic antidepressants. Nortriptyline specifically was found to relieve dizziness in 46% of patients who combined the medication with lifestyle changes that included addressing triggers related to diet, behavior, and sleep hygiene
It seems these medications work well for patients who may also have sleep disturbances or who also experience an anxiety component to their attacks. It also appears that medication is even more effective when supported by other areas of treatment, like keeping a sleep schedule and avoiding potential food triggers.
How Does My Doctor Rule Out Something Else
Theyâll likely order an MRI to check your brain and run hearing and balance tests to look for problems with your ears.
- Meniere’s disease. Before you get dizzy, usually one of your ears feels full or stuffy, or hurts. During an attack, one or both ears may ring, or you might lose hearing. This doesn’t usually happen with a vestibular migraine.
- Brainstem stroke. Along with vertigo, you mayalso have numbness, weakness, trouble speaking, and other stroke symptoms. If you have any of these symptoms, or if you have new vertigo that has not been diagnosed, get immediate emergency help.
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The Vestibular Migraine Recovery Plan That Ended My Daily Dizziness
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Most people consider migraine to be a terrible headache that lasts a couple of hours and then the person recovers and feels better. But, thats far from the reality of what its like living with migraine disease. Migraine is actually a neurological condition that along with intense head pain causes the brain to have an inappropriate response to stimuli also called triggers. Stimuli include lights, sounds, scents, hormones, weather, sleep disturbances, stress, dehydration, chemicals in foods and in the environment and so much more. These factors are easily ignored by those without migraine, but for those with migraine, it can feel like an assault to our senses and create debilitating symptoms. Migraine brains love consistency, so basically any change can trigger an attack in a hyper-responsive migraine brain. Stay with me as I take you through a bit more about vestibular migraine and then share with you the detailed plan I follow for vestibular migraine recovery.
** This is not medical advice or a substitute for medical advice. The purpose of this article is to share information and my personal experience. Consult your doctor before making any changes to your own treatment plan.
Mindfulness For Stress Busting
We have to understand the play here between our nervous system and our everything else.
The mind and body are completely interconnected.
The mind talks to the body using the nervous system which connects our entire body together.
When the mind feels a certain way, the body reacts.
What the mind does, the body follows. Always.
So if we are stressed or even perceive that we are stressed
Our body will think we are stressed as well.
It will release stress hormones, use up nutrients and resources and prepare us to deal with that stress.
But if that stress never goes away, if we are stressed because of a relationship or work or just an extremely obsessive personality
Then our body will constantly be burning resources that could be used to repair the brain.
If our body is on fight or flight mode, its not on rest and digest mode.
This causes our trigger levels to go through the roof.
So finding a simple way to drop the stress, and keep dropping it throughout the day, can keep us in rest and digest mode where we are lowering our trigger levels, not raising them.
One of the easiest ways to do this is mindfulness.
Mind-ful-ness is the practice of filling your mind with what is going on in your body.
Simply stop everything you are doing, bring your focus into your self and onto your body.
Where are you holding your tension? Let it go, relax, drop your shoulders and breathe in through your stomach.
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What Are The Common Symptoms Of Vestibular Migraine
People with vestibular migraine may have any combination of the following list of common symptoms. They may or may not have headache pain as a symptom:
- Sensitivity to scents and fragrance
- Vertigo or a sense of movement when youre not moving at all.
I experienced every symptom above. Many of you know that I was housebound for many months, too dizzy to leave the house. I fought my way out of those daily symptoms and now I work full time and live a full, active life. I get so many questions about what I did to get better that I thought Id write out my vestibular migraine recovery plan for anyone whos interested.
My Vestibular Migraine Recovery Goal
The main goal of my treatment plan is to calm down my hyper-responsive, over sensitive and dizzy migraine brain so I can live a normal, active life without having to constantly manage and think about triggers. I firmly believe if you are new to VM your goal in life should be to calm your brain down. I accomplished that through a three-part migraine recovery treatment plan that includes preventive, abortive and rescue strategies. There are MANY pieces to each part. You will see some overlap as some fit into more than one category.
1. My Preventive Plan
The Details of My Migraine Recovery Plan for Prevention
Hydration Hydrate, hydrate, hydrate! Your brain needs to be properly hydrated to recover. I am ALWAYS working on this. Why is drinking a daily adequate amount of water so hard?
3. The Details of My Rescue plan
What Is Vestibular Migraine
Vestibular migraine is a variant and less common form of migraine that adds inappropriate processing of movement to the list of triggers above. Some experience head pain but others with vestibular migraine experience no pain at all. Instead, our movement sensitivity causes vestibular symptomssuch as disorientation, visual disturbances, nausea, loss of balance, vertigo and vomiting.
Sensitivity to movement in vestibular migraine includes visual movement like seeing trees swaying, water rippling, cars passing by, busy crowded rooms and movement seen on screens like tablets and phones. It also includes sensitivity to physical movement like walking, riding a bike or riding in a vehicle. Many with VM are so sensitive to movement that even the movement of our own bodies such as shifting your eye gaze to scan a room, bending down to pick something up off the floor or turning your head can cause dizziness. So both movement we see and movement we feel can create symptoms.
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Learn About The Symptoms Treatment Options And Action Steps For This Specific Type Of Migraine That Affects Balance
For many people, a migraine attack includes severe head pain. Its the kind that makes you want to lay in a dark room until it passes. But its important to remember that not all types of migraine look or feel the same. Vestibular migraine, for example, affects your sense of balance. Often during an attack, you can feel like youre moving, falling or spinning when youre actually sitting still. We call this sensation vertigo. Alongside vertigo, a vestibular migraine can also include more typical migraine symptoms such as sound sensitivity, light sensitivity and often ear pain, pressure or ringingbut not necessarily headache. We turned to Dr. Shin Beh, founding director of UT Southwestern Medical Centers Vestibular and Neuro-Visual Disorders Clinic, to give us insight into this particular type of migraine.
An Insiders Advice On How To Conquer Vestibular Migraine
Even before her diagnosis, she knew something was wrong. Her symptoms made it nearly impossible to function from day-to-day.
Looking at a computer or tablet screen was enough to create debilitating dizziness and nausea. Even setting foot in an artificially-lit store like Target would trigger a migraine attack so severe that they knocked Kayla off her feet.
But fast forward to today and Kayla McCain has learned how to live with her diagnosis, something known as a vestibular disorder i.e. vestibular migraine. Through plenty of trial and error, Kayla has learned what works and what doesnt. She now hopes her story and personal experiences can help others living with vestibular migraine regain some comfort in their own lives.
What is Vestibular Disorder?
The vestibular system is a part of human anatomy that includes the parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements. And when the system is damaged, people can suffer from a range of symptoms including vertigo, vision disturbances, hearing imbalances, migraines and more.
In Kaylas case, she experiences constant dizziness, blurry vision, auras, and what she calls dirty vision . The worst part about her vestibular migraine, though, is that it is a type of migraine that can attack without a precursor headache. So instead of being tipped off by pain, she experiences the aforementioned symptoms without warning.
Treating Vestibular Migraine
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