How do you recognize vestibular migraine?

Vestibular migraine is a specific form of migraine where the balance system is affected, leading to dizziness and balance problems alongside the familiar headache associated with migraine. This form of migraine is often not recognised because symptoms can occur without headache. Recognition is important because migraine triggers and treatment differ from ordinary migraine.

What is vestibular migraine and how does it differ from ordinary migraine?

Vestibular migraine is a neurological condition where the balance system in the inner ear is affected by migrainous processes. Unlike classic migraine, dizziness takes centre stage here rather than headache. This form occurs in approximately 1% of the population and is often missed during diagnosis.

The main difference from ordinary migraine lies in the symptoms. Where traditional migraine is characterised primarily by throbbing headache and sensitivity to light and sound, vestibular migraine mainly causes balance problems. People can experience attacks without any headache, which makes diagnosis difficult.

The condition is often overlooked because doctors and patients do not expect that migraine can occur without headache. The nervous system that causes migraine also affects the balance organs in the inner ear. This explains why movement and certain migraine triggers, such as stress, hormonal changes and certain foods, can also trigger vestibular symptoms.

Which symptoms specifically indicate vestibular migraine?

The characteristic symptoms of vestibular migraine include various forms of dizziness, motion sensitivity and visual disturbances. Spinning dizziness, unsteady gait and the feeling as if the surroundings are moving are the most common complaints. These symptoms can persist for minutes to days.

Specific symptoms that indicate vestibular migraine are:

• Spontaneous spinning dizziness without clear cause
• Motion sensitivity, where head movements worsen the dizziness
• Visual disturbances, such as aura spots or light flashes
• Balance problems when walking or standing
• Nausea and vomiting during attacks
• Sensitivity to movement, light and sound
• Headache that may occur before, during or after the dizziness

These symptoms distinguish themselves from other dizziness complaints through their episodic character and the presence of migraine-related phenomena. Migraine advice, such as avoiding known triggers, can also help prevent vestibular attacks.

How can you distinguish vestibular migraine from other dizziness complaints?

Vestibular migraine distinguishes itself from other dizziness complaints through specific characteristics and the course of symptoms. BPPV (benign paroxysmal positional vertigo) causes brief attacks with head movements, whilst vestibular migraine lasts longer and can occur spontaneously, without movement.

Important distinguishing factors are:

• Duration of attacks: Vestibular migraine lasts hours to days, BPPV only seconds to minutes
• Triggers: Migraine triggers such as stress, hormonal fluctuations and diet play a role in vestibular migraine
• Additional symptoms: Light and sound sensitivity indicate migraine
• Family history: Migraine often runs in families

Labyrinthitis usually causes suddenly occurring, persistent dizziness with hearing loss. Ménière’s disease is accompanied by hearing loss, tinnitus and a full feeling in the ear. Vestibular migraine usually does not have these hearing complaints and shows a clear episodic pattern that corresponds with other migraine attacks.

When should you see a doctor if you suspect vestibular migraine?

You should seek professional help for recurring dizziness attacks that affect your daily functioning, especially when these are accompanied by headache, nausea or sensitivity to light and sound. Sudden, severe dizziness with neurological symptoms requires acute medical care.

Warning signs that require immediate medical attention:

• Sudden, severe dizziness with headache
• Dizziness with speech disorders or paralysis symptoms
• Hearing loss during dizziness attacks
• Persistent balance problems that make walking difficult
• Frequent attacks that disrupt work or daily activities

A neurologist or ENT doctor can diagnose vestibular migraine. The diagnostic process usually includes an extensive medical history, neurological examination and sometimes balance tests. Often a symptom diary is kept to identify the connection between triggers and attacks. The diagnosis is made based on the criteria of the International Classification of Headache Disorders.

How Ruggensteun helps with vestibular migraine

We approach vestibular migraine from a holistic perspective, where the spine and nervous system are central. Through careful alignment of the spine we improve nerve communication between brain and body, which activates the body’s self-healing capacity.

Our treatment approach for vestibular migraine includes:

• Spinal correction: Specific adjustments to reduce pressure on nerves
• Cranial Facial Release (CFR): Technique focused on the head and neck area
• Nervous system optimisation: Improvement of communication between nervous system and balance organs
• Preventive care: Advice about migraine triggers and lifestyle adjustments

Our specialised chiropractors have expertise in neurological problems and understand the complex relationship between the spine, nervous system and vestibular symptoms. We offer quick availability for acute cases and work without referral from the GP.

Would you like to know more about our migraine treatments or do you have questions about vestibular migraine? Please contact us for a personal consultation. Visit our practice in Eindhoven or Valkenswaard and experience how our holistic approach can help you find relief.