Vertiginous Migraine is a common condition. It is more common in women than men. Some studies estimate it may occur in up to 30% of women in their thirties.
Previously, the association between dizziness/imbalance and migraine was not widely recognized. It is however one of the commonest forms of dizziness and patients can suffer for many years before the connection is made and appropriate treatment given.
Patients with this condition typically give a history of episodes of imbalance or dizziness, which can vary greatly in intensity. Symptoms range from a feeling which makes it difficult to function properly to a raging sensation of spinning which is so severe that it renders them incapable of anything other than vomiting and lying still.
Frustratingly for doctors trying to make an accurate diagnosis, headache does not always accompany the dizziness.
Several features are often present in these patients:
- They tend to be female
- They have often been previously diagnosed as having migraine
- Almost half have a history of travel sickness (a much greater incidence than the general population)
- The dizzy/imbalance symptoms can be made much worse by loud noises (phonophobia) or bright lights (photophobia)
- Unlike Menieres disease (see Menieres page) there is unlikely to be associated hearing loss or tinnitus with the dizzy spell.
- Although the room may spin, many patients describe episodes of poor balance rather than rotation.
- Episodes can last days or weeks.
- The dizzy episodes may be worse at certain times of the menstrual cycle.
Management of Vertiginous Migraine
Although patients are often already on treatment for migraine headaches, some of these drugs are ineffective for the balance problem associated with migraine.
It is important to look at foodstuffs such as caffeine, chocolate, alcohol, cheese, and Chinese food as possible triggers of the problem. Keeping a food diary allows patients to match symptom times with food intake over the previous 48 hours. Other triggers such as stress or infections also need to be identified.
Establishing control of the condition requires customizing medication treatment to the patients needs and should be done by a doctor with a good understanding of the condition.