Is vestibular migraine a chronic illness? What is the best treatment for this?

We've been getting a lot of inquiries recently about vestibular migraines –it's a particularly hot topic. So today I'm going through where does this dizziness actually come from and most importantly, what can you do to help this dizziness?

Hi, I'm Dr. Beth, osteopath here at Melbourne Headache Solutions.

Vestibular migraine is the migraine that is commonly associated with dizziness as the predominant symptom. You can get it with or without head pain and most commonly, you get other associated features like nausea, light, and sound sensitivity. This migraine type can either be episodic or constant. In episodic vestibular migraine, they turn on and off and usually last between 4-72 hours and then in between episodes, you don't have dizziness. However, if you get vestibular migraines that are constant, you can feel dizziness all the time, you have spikes in your dizziness that usually last between 4-72 hours where it's more intense. So, you can either get it all the time, or you can just get spikes in the dizziness, but be fine in between times. These two are the most common presentations of vestibular migraine.

 

Where does vestibular migraine actually come from?

We have our vestibular system, which is our balance system. This system creates a 3D map of where we are in space and lets us know where we are in relation to other objects and where other objects are in relation to us. When this is disrupted, we feel dizzy. When it comes time for a vestibular migraine though, the information that our balance system is receiving is not disrupted –the information is okay. It's actually the processing of these information that gets disrupted causing us to feel that dizziness.

The processing center of information is known as the brainstem. When the brainstem becomes hyper-excitable or it becomes sensitized, all the information that we receive from areas like our ears and eyes, gets muddled. So, it receives the information just fine, but it can't process it properly because it's too excited, it's hypertensive. Thus, we get the sensation of dizziness and as I said, we can get those other associated features like nausea, light, sensitivity, and you can get head pain as well.

What we need to do is we need to decrease that sensitivity of the brainstem back down to a more normal level so it can process the information that we're receiving from our vestibular system properly. If this happens, we then no longer feel dizzy and get those sensations of either rocking, swaying, lightheadedness, off balance, and those sorts of things.

 

How do we get this dizziness in the first place?

There are many things that can contribute to vestibular migraine and that increased sensitivity level of our brainstem. One of the most common things and one of the biggest factors is the top three joints of our neck. The lower part of the brainstem is housed in the upper part of the neck and chronic dysfunctions can contribute to the sensitivity level of our brainstem. This in turn, can lead to vestibular migraines. Things like trauma, extended periods of bad posture, poking your head forward, looking down for long periods of time, and stomach sleeping can all contribute to vestibular migraines. Things like increased stress, bad diets, nutritional deficiencies, and hormonal issues can also contribute to this type of migraine as well. But a major contributor is the top three joints of the neck. So, if we assess it and treat it in a thoughtful manner, then we often see significant changes to vestibular migraines.

Stress and anxiety are definitely big factors when it comes time for any dizziness condition as well as our hormones. Commonly, we see a spike in dizziness often around women and their menstrual cycle. We need to address these deficiencies and take supplements like magnesium. We also need to make sure that we have a good diet and most importantly, have a well-established sleeping routine.

It is very common that people are diagnosed with vestibular migraine when actually they have a vestibular disorder. So, you do want to make sure that you've got the right diagnosis, because as I said, vestibular migraine is a disturbance in the processing of information and not a problem with your actual vestibular system. A vestibular disorder is when you've actually got an issue with your vestibular system, which means you need to be treated differently. You need vestibular rehab exercises so that you can retrain the vestibular system and the information that you're getting is actually accurate. So, you want to make sure that you've got a right diagnosis so that you're being treated accurately.

That's what we do here at Melbourne Headache Solutions. We make sure that you've got the right diagnosis so that you've got the right treatment approach. And sometimes you've got both going on at the same time and we make sure that we're treating you in the right way.

If you're suffering vestibular migraines, let us know. And if you've got any questions or queries, please let us know. We’d love to hear from you and help you with your headaches and migraines.

Stay in touch with us at (03) 9486 7543 or you can book your FREE consultation with us through here.