Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisOther Causes of DizzinessTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Other Causes of Dizziness
Treatment
It’s thought that around 10 percent of people with migraines suffer from the vestibular variety.
Verywell / Cindy Chung
The vestibular system is that part of the inner ear, which tells us where we are in space in three dimensions. If you’ve ever spun in circles rapidly and then stopped, you know what happens when your vestibular system isn’t working properly.
Also called a migraine associated with vertigo (MAV), or migrainous vertigo, vestibular migraine is acommon cause of sudden vertigo(dizziness)—that is, feeling that you are spinning or the world is spinning around you.
Symptoms of vestibular migraines can include one or more specific types of vertigo, including:
The causes of migraine disease are generally not well understood, and causes of vestibular migraine are even less so. The belief is that abnormal brainstem activity changes how we normally interpret our senses, including pain, and alters blood flow through the arteries in the head as well.
There are mechanisms thought to be activated that link the trigeminal system (a part of the brain activated during migraines) to the vestibular system.
The association betweenhemiplegic migraineandepisodic ataxia type 2with mutations in the CACNA1A gene have raised the question of a possible connection between vestibular migraines and abnormalities in this gene. Other mutations in the ATP1A2 and SCN1A genes have also been studied in patients with vestibular migraines, but without a conclusive relationship so far.
All of these genes are related to ion channels that control how electricity travels in the brain.
Vestibular migraines usually occur in people with an established history of common migraines—also calledmigraine without aura—yet it’s important to note that vestibular migraines are underdiagnosed.
Like other forms of a migraine, vestibular migraine is more common in women than men. These migraines often make their appearance between the ages of 20 and 40 but can begin in childhood. For women, a worsening of symptoms is often noted in the pre-menstrual period. Vestibular migraines are known to run in families.
Genes and Your Migraines
To make the diagnosis of a vestibular migraine, there are certain criteria that must be met. The diagnosis is usually made based on your history, your symptoms, the degree of your symptoms, the length of your episodes, and your history of migraines in the past.
Most of the time, a physical exam, as well as laboratory tests and imaging studies, are normal. While 40 percent of people with migraines have some vestibular symptoms, thesespecificsymptoms must be present to diagnose vestibular migraines, per the Bárány Society’s Classification of Vestibular Symptoms:
What Migraine Aura Feels Like
Differential Diagnoses
Otherpossibly dangerous causes of dizzinessmust be ruled out before the diagnosis can be made. These include:
Possible Causes of Dizziness
Treatment and Prevention
The treatment of a vestibular migraine is similar toother migraine therapiesand usually includes a combination of several treatment modalities. With regard tomedications, oftentimes the drugs that relieve dizziness do not improve headaches and vice versa.
Treatments and prevention strategies include:
A Word From Verywell
Vestibular migraines can have a very significant impact on your life. Due to this, it’s important to create a comprehensive treatment plan if you experience them, including not only medications, lifestyle changes, and behavioral approaches, but also the avoidance of triggers.
It can be frustrating coping with these symptoms, and you may feel isolated because of them. There is a large community of people you can turn to for tips and advice. You may have a support group in your community, but there are many online vestibular migraine support communities available as well.
Recognizing Your Migraine Triggers
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Vestibular Disorders Association (VeDA).Vestibular migraine.
Sohn JH.Recent advances in the understanding of vestibular migraine.Behav Neurol. 2016;2016:1801845. doi:10.1155/2016/1801845
Espinosa-sanchez JM, Lopez-escamez JA.New insights into pathophysiology of vestibular migraine.Front Neurol. 2015;6:12. doi:10.3389/fneur.2015.00012
Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, Bisdorff A, Versino M, Evers S, Kheradmand A, Newman-Toker D.Vestibular migraine: Diagnostic criteria1. J Vestib Res. 2022;32(1):1-6. doi: 10.3233/VES-201644.
VeDA.Benign paroxysmal positional vertigo (BPPV).
Liu YF, Xu H.The Intimate Relationship between Vestibular Migraine and Meniere Disease: A Review of Pathogenesis and Presentation. Behav Neurol. 2016;2016:3182735. doi: 10.1155/2016/3182735
Dieterich M, Obermann M, Celebisoy N.Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol. 2016 Apr;263 Suppl 1:S82-9. doi: 10.1007/s00415-015-7905-2
Sprenger T, Viana M, Tassorelli C.Current Prophylactic Medications for Migraine and Their Potential Mechanisms of Action. Neurotherapeutics. 2018 Apr;15(2):313-323. doi: 10.1007/s13311-018-0621-8
Flake, ZA, Linn, BS, Hornecker, JR.Practical selection of antiemetics in the ambulatory setting.American Family Physician. 2015;(91)5.
Dieterich, M., Obermann, M., and N. Celebisoy.A vestibular migraine: The most frequent entity of episodic vertigo.Journal of Neurology. 2016. 263 Suppl 1: S82-9. doi: 10.1007/s00415-015-7905-2Sohn, J.Recent Advances in the Understanding of Vestibular Migraine.Behavioral Neurology. 2016. 2016:1801845. doi: 10.1155/2016/1801845
Dieterich, M., Obermann, M., and N. Celebisoy.A vestibular migraine: The most frequent entity of episodic vertigo.Journal of Neurology. 2016. 263 Suppl 1: S82-9. doi: 10.1007/s00415-015-7905-2
Sohn, J.Recent Advances in the Understanding of Vestibular Migraine.Behavioral Neurology. 2016. 2016:1801845. doi: 10.1155/2016/1801845
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