Vestibular migraines confuse patients and practitioners alike. This is because vestibular migraines do not present as what most of us would consider as a migraine. Rather, a vestibular migraine is characterized by:
- Dizziness and/or Vertigo (commonly symptoms of rocking and bobbing).
- Headaches which may not seem that severe and accompany the dizziness and or vertigo about 50% of the time.
- A history of migraines
- Light and Sound Sensitivity
It has been widely acknowledged in the literature that vestibular migraines are the most common cause of episodic vertigo, yet they are often underdiagnosed. In fact, in some specialty dizziness centers, 1% of the patients are referred with a diagnosis of Vestibular Migraines, but after being seen by specialists, it is deemed that about 20% of those referred actually have Vestibular Migraines!
How does a standard migraine differ from a vestibular migraine? A standard migraine is a unilateral, pulsatile headache that inhibits activities of daily living and is associated with light and sound sensitivity, nausea or vomiting, changes in vision such as seeing auras or zig zags, and other neurological symptoms such as double vision or tingling on one side of the face or body. As noted above, a vestibular migraine is categorized as vertigo, dizziness, head motion induced vertigo, and rocking or bobbing being present 50% of the time, headaches or a history of migraines, light and sound sensitivity. The vestibular symptoms are significant but do not inhibit activities of daily living and the vestibular symptoms last 5 minutes to 3 days.
So, if you have moderate to severe headaches, vestibular symptoms like rocking or swaying (sometimes there is no headache when there are vestibular symptoms), light and sound sensitivity and a history of migraines, you may have vestibular migraines.
Frequently in our experience, there is an autoimmune thyroid or celiac disease component to vestibular migraines. From a functional medicine perspective, the goal is to help the immune system regulate itself better so blood flow can increase to the brain.
Here at Gates Brain Health, we use state of the art videonystagmography testing. Most often used by ENT specialists, VNG testing allows for Dr. Gates to see what is really going on patients’ brains. This is especially helpful for people with Vestibular Migraines, as Dr. Gates can functionally test the health of the cerebellum.