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Vestibular Migraine Treatment

Vestibular Migraine Treatment

What is a vestibular migraine?

Migraines in general are considered to be a neurological syndrome. According to the ICHD International Classification of Headaches Disorders it is estimated that 11% or (303 million) of the global population experiences migraines. The ICHD recognizes vestibular migraines as a subtype of migraines. A large percentage of migraine patients do not have a headache as their dominant symptom. These patients describe symptoms that include constant dizziness, movement triggered dizziness, nausea and vomiting, blurred vision, light +/or noise sensitivity, imbalance, anxiety and difficulty concentrating. These symptoms can occur with a headache, after a headache or without any headache at all.

Some people experience auras prior to a migraine. A migraine aura can consist of attacks of reversible focal neurological symptoms that lasts less than 60 minutes. Symptoms can include: flashing lights, spots or lines, loss of vision, numbness, pins and needles, dysphagic speech disturbance (difficulty speaking) and or motor weakness.

What is the cause?

Migraine is problem of ion channels in the brain and abnormal electrical activity.

Migraine syndromes tend to run in families. Females are 3 times more likely to have migraines than males. They are often provoked by triggers such as barometric pressure changes, fluorescent lights, alcohol, lack of sleep, dehydration, hunger, certain foods, stress, strong smells and menstruation/ hormone changes.
How do you treat vestibular migraines?
Exploring lifestyle modifications and adaptations is extremely important in limiting the number and severity of attacks. Your healthcare provider is a great resource for these modifications.
Identifying and avoiding triggers is extremely important in treating migraines. Aerobic exercise, relaxation and consistency of a daily schedule is also important (not skipping meals, hydration, regular bedtime).

New in migraine treatment are lifestyle devices or neuromodulators. These devices use electrical or magnetic pulses to calm the electrical wave and/or vagus nerve such as nausea and sweating associated with migraine. Ask your healthcare provider for more information.
Medical management is also sometimes necessary. This can include: beta blockers, calcium channel blockers, tricyclic antidepressants, SSRI or SNRI’s, or topiramate.
What type of doctor should you go to?
A neurologist to assess and treat dizziness and for medical management for headaches and /or migraines with dizziness.

An otolaryngologist to assess and treat dizziness and provide a full ear work up with an audiological exam.

A vestibular rehabilitation specialist is extremely effective in identifying triggers, symptom management and prevention of vestibular migraines.
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