Headaches and dizziness: it could be vestibular migraine

Often headaches and dizziness coexist: this is the case with vestibular migraine. Dizziness is characterised by the sensation that the body is moving relative to the environment or vice versa; in most patients with vestibular migraine, the dizziness is felt independently of the headache

Other forms of headache can also be related to vertigo, such as tension-type headache, especially when associated with cerviconucal muscle contracture, and chronic headache, especially in the presence of sleep disturbances and medication abuse.

Headache and dizziness may also be associated with cerebral vascular disease (such as vertebral artery dissection, ischaemia or haemorrhage in the posterior cranial fossa), endocranial hypertension, neoplasms, cerebral or systemic infections, cranio-cervical trauma, Arnold Chiari malformation or homeostasis disorders.

How is vestibular migraine diagnosed?

The diagnosis of vestibular migraine is based on criteria defined by the International Headache Society.

There must be at least five crises characterised by so-called vestibular symptoms, of moderate or severe intensity, lasting from five minutes to 72 hours.

Vestibular symptoms are internal vertigo, when the patient feels a movement of the body in relation to the environment; external vertigo, when it seems that the environment is moving in relation to oneself; positional vertigo, due to a change in head position; vertigo triggered by visual stimuli or head movements.

Dizziness due to head movements may also be present the presence of nausea.

In at least half of these episodes, at least one of the characteristics of migraine must be present: throbbing pain, unilateral pain, headaches that worsen with movement (such as walking), photophobia, phonophobia or visual aura (presence of twinkling lights and zigzag lines in the visual field).

Other vestibular disorders should also be ruled out and the association with migraine, with or without aura, should be taken into account.

Vestibular migraine: drug treatment and lifestyle

After diagnosis, the specialist will determine the most appropriate type of therapy.

Medications such as beta-histine, levosulpiride, dihydroergotamine, cinnarizine, dimenindrinate and corticosteroids may be indicated to treat vestibular migraine.

Lifestyle plays a fundamental role: a correct dietary-nutritional approach and regular sleep can help reduce the frequency and intensity of crises.

It is therefore advisable to follow a healthy diet that includes cereals, fruit, vegetables, legumes and fish, as well as adequate hydration.

Read Also:

Migraine And Tension-Type Headache: How To Distinguish Between Them?

Paroxysmal Positional Vertigo (BPPV), What Is It?


Humanitas Research Hospital

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