Migraine is a neurological disorder characterized by a throbbing pain on one side of the head which leads to moderate to severe headaches with certain symptoms like nausea, vomiting, dizziness, sensitivity to light, sound and odours etc,
Vertigo is when a person feels as if they or the objects around them are moving when actually they are not, often it feels like spinning or swaying movement. It may be associated with nausea, vomiting, sweating, or difficulties walking. It is typically worsened when the head is moved, vertigo is the most common type of dizziness.
A Migraine Associated Vertigo (MAV) also termed as Vestibular Migraine, Migrainous Vertigo, or Migraine related vestibulopathy. MAV is vertigo associated with a migraine referred either as a symptom of a migraine or as related to a migraine, however, it is a neurological disorder. Some authors believe that Migraine associated Vertigo (MAV) is neither clinically nor biologically acceptable as a migraine variant. Epidemiological studies leave no doubt that there is a strong link between vertigo and migraine.
A migraine associated vertigo may occur between the ages of 20 and 40 for most women and slightly higher range for men. The vertigo attacks are generally parallel with a headache. Sometimes the episodes of vertigo occur with or without a migraine headache.
Classification of Migraine Associated Vertigo
- Benign paroxysmal positional vertigo– is a disorder arises in the inner ear with a spinning sensation and is commonly associated with a migraine, the most common vestibular disorder in patients bestowing with dizziness, the two may be linked to genetic factors.
- Meniere’s disease– is also a disorder arises in the inner ear which damages the hearing and balance and has an increased frequency of a migraine in patients which leads to a greater liability of developing Meniere’s disease. However, these two can be differentiated. Meniere’s disease may go on for days or even years while migraines typically do not last longer than 24 hours.
- Motion Sickness– is more common in patients with a migraine
- Psychiatric syndromes- dizziness and spinning vertigo are the second most common symptom of panic attacks, and they can also be a symptom of major depression. A migraine is a risk factor for developing major depression and panic disorder and vice versa.
Signs and Symptoms of Migraine Associated Vertigo
- Motion sickness
- Dizziness refers to a feeling of light-headedness, giddiness, drowsiness
- Nausea
- Sensitivity of light, sound, odours
- Auditory symptoms such as fluctuating hearing loss or unilateral tinnitus
- Benign paroxysmal vertigo is an example of migraine-associated vertigo in which a headache does not often occur.
- Ataxia (lack of muscle coordination)
- Dysarthria(speech disorder)
- Visual symptoms in both eyes
- Loss of consciousness followed by throbbing headache.
Food triggers of MAV
- Aged cheese
- Foods containing Monosodium Glutamate (MSG)
- Alcohol
- Chocolate
- Buttermilk, Yogurt and Sour cream
- Processed meat
- Artificial sweeteners
- Excessive tea and coffee
Diagnosis of Migraine Associated Vertigo
- Current or previous history of a migraine
- Migraine symptoms like photophobia (sensitivity to light), phonophobia (sensitivity to sound), visual or other auras during two or more vertigo attacks.
- Vestibular symptoms(dizziness, motion sickness) from moderate to severity
- Food triggers, sleep irregularities, hormonal changes during vertigo
- History of motion intolerance, illusions, and vertigo that awakens the patient.
- Additional causes administered by proper investigations
Treatment for Migraine Associated Vertigo
Vestibular migraine treatment is same as the treatment for a migraine. The medications used for preventing migraine are beta blockers, calcium channel blockers, antidepressants medicines. But then again, each patient’s migraine is different and not every medication will affect every patient. Moreover, every medication will have its own side effects and the best medication should have conversed with patient’s health care provider. Maintaining a healthy lifestyle with regular exercise, avoiding trigger factors and taking balanced meals, encouraging healthy sleep habits can be helpful in managing migraine and other migraine related disorders.