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Vestibular Migraine: How To Treat & Manage It Better

Written and verified by Holly Hazen

8 Treatment Tips for Managing Vestibular Migraine @migrainesavvyBest Management Practices For Vestibular Migraine @migrainesavvy

Migraines are a brain disorder and they cause a variety of symptoms. Vestibular Migraines occur in the vestibular system and they cause vertigo, dizziness, motion sensitivity, and more.

Approximately 40% of migraine sufferers have some vestibular disruption in their balance and/or dizziness at some time along their journey. [1] Vestibular migraines may only last a few minutes, or they can persist for days… or, in my case, months. Typically not more than 72 hours.

Learn to manage them better with these 8 best management practices below.

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I had never even heard of vestibular migraine before my friend told me about her migraine associated vertigo. Johns Hopkins Medicine Neurology and Neurosurgery department says that the dizziness associated with this type of migraine is due to disturbances in "the inner ear and brain mechanisms that influence hearing and balance."

Most of us never connect that migraines also effect the inner ear, but it sure explains why you can get so dizzy and off balance.

This chronic dizziness related to this type of migraine is a syndrome called MAV (Migraine Associated Vertigo). Research is being done through clinical trials and genetics in an attempt to find the cause for MAV, but at this time, the cause is still unknown.

Here are some of the more common vestibular migraine symptoms:

  • Vertigo or dizziness
  • Imbalance (Ataxia)
  • Spatial Disorientation
  • Nausea
  • Unsteadiness
  • Difficulty walking and standing
  • Extreme sensitivity to motion
  • Hearing symptoms like: muffled hearing, Tinnitus or ringing in the ear
  • Feeling a strange 'fullness' in the head, pressure
  • Headache
  • Anxiety
  • Visual Aura
  • Facial numbness or tingling

Vestibular migraine often occurs without pain and the symptoms can occur away from the attack. Meaning it can be very confusing for you and your doctor to pinpoint a diagnosis. 

Treatment Tips for Vestibular Migraine @migrainesavvy

You Are Not Alone... It's More Common Than You Think

My friend described the feeling she gets is like a fullness in the head because of the inner ear disturbances.

She said it caused a great deal of anxiety for her before she got diagnosed.

She felt so strange and just had no explanations at the time. But, she considers herself lucky, she found a good neurologist early on.

Some people spend a few years having major tests with specialists before finding out they just have vestibular migraine. And it can take some time to figure out just how to best deal with this somewhat rare form of migraine attack.

She said that fluctuating hormone levels also impact it as does stress. And I think a major thing worth noting is that neck and back problems often can be a huge part of the problem. She said getting work done on her neck makes a big difference. "There have been times that I have been totally unaware that my neck was out simply because I was more concerned with the migraine I was living with day to day."

So, you see, people can sometimes not be aware that they have neck, back pain, or other pain issues as well when the other symptoms of migraine are too loud.

If you suspect you have this condition then I recommend you seek out a good neurologist with an interest in vestibular migraine or at least migraine headaches, or an ENT Specialist.

Your crucial first step is to get the right diagnosis.

A while ago I had a huge change in symptoms and was diagnosed with Vestibular migraine or Vestibular neuronitis - he (the specialist) wasn't sure!

I never suspected migraine until I saw this list of doctors: 2 physicians that told me to ignore it and go home! My nutritionist specialist who sent me for: an MRI, a hearing test, and then onto a Ear, Nose and Throat specialist.

This was by far... my most expensive migraine ever!

It was horrific. I could not move my head at all and vomited if I moved for 12 whole hours. It took almost a week for the nausea to pass. My hearing was one sided for over 3 months. I could barely walk or eat for that time. 

You might like to read my article on migraine associated vertigo as well for some Do's and Don'ts. 

You'll need to learn a whole new way to function.

How To Treat & Manage Vestibular Migraine Better @migrainesavvy

How To Treat & Manage Vestibular Migraine Better

The fact that these strange and unfamiliar symptoms are not typically accompanied by a headache, a great deal of the time, can make it harder to understand.

The same treatments used for classical migraines are used to help vestibular migraine.

Here's what you can do:

1. Get the right diagnosis and the right medications

See your doctor to help find the best prophylactic medication(s). You will have a number of effective ones to choose from: beta blockers, calcium channel blockers, tricyclic antidepressants, SSRI’s, Gabapentin or Neurontin, Clonazepam, or Topamax just to name a few. 

I took Serc (Betahistine Dihydrochloride) which was VERY effective... thank goodness.

2. See the right professionals

Your general physician will most likely not deal with this type of specialized migraine. Make sure you see the right specialist to help you treat and manage this condition.

Consult with a qualified neurologist, and even for a second opinion (which never hurts) an Ear, Nose and Throat specialist (ENT).

3. Avoid your triggers

There are so many triggers you can't control - weather, hormones, people wearing perfume at work... but there are also some you can control that can make a huge difference. 

Avoid foods with as MSG (monosodium glutamate), certain alcoholic beverages such as red wine, certain cheeses, chocolate, and artificial sweeteners like aspartame. Anything could set off an attack for you if it is your trigger.

4. Learn some stress management techniques

Learn to reduce stress and anxiety in your life where you can. 

Guided meditations or biofeedback can help. Here are some to get you started - Meditation for Migraines - Imagine A Migraine Free Life

5. Don't smoke

Don’t smoke and avoid wearing perfumes. Yes, perfume is a very common migraine headache trigger

6. Avoid excess

Watch for patterns and avoid overdoing it when you feel the sensations looming in the background.

Avoid excessive salt around your menstrual period if these attacks tend to occur around the same time.

7. Explore vestibular rehabilitation treatment

Vestibular rehabilitation therapy can be essential in order to help you recover or for you to find a new way to be in the world.

You may have to deal with this long term, so the exercises you learn could be invaluable.

Click here to go straight to the links at the bottom of the page.

8. Experiment with complementary therapies

Experiment with having treatments from a qualified Chiropractor or Osteopath and see if neck or back structural problems are triggering your attacks.  

There are some beneficial supplements with good evidence behind them like: Magnesium, Vitamin B2 (Riboflavin), and butterbur. You can read more about that here - The Top 6 Supplements For Migraines

The experts at Johns Hopkins Medicine tell us in a positive note that "for almost all patients, the proper combination of diet, exercise and drug treatment (if necessary) will lead to good relief of symptoms and return of a normal lifestyle." [2]

So, please know that there is hope for this type of migraine. It's not just me being positive for you. My friend leads a normal, healthy, happy life with her migraine management strategy securely in place.

Some Basic Facts To Be Aware Of

We both know that there are just some things in life that you can't do anything about. And when it comes to migraines, a lot is out of our control.

Here are some basic facts for you to be aware of:

Fact 1: Vestibular migraine is really common. It's estimated in the millions.

Fact 2: The pathophysiology (pathology with physiology) of the workings of this type of migraine is still not well understood.

Fact 3: There are no objective tests for diagnosing this condition. Your doctors will run tests to rule out any other serious illnesses first. 

Fact 4: Treatment for this type of migraine is basically the same as it is for classical migraine headaches. You can consider taking medication(s) to manage the symptoms and learn to make different lifestyle choices that nourish your health.

Fact 5: It is a complex life altering condition and it is NOT to be taken lightly.

This is a lifelong condition, however my friends specialist did say it might just stop one day. She is still waiting!

You will need to learn to manage this condition. Learning new coping skills will definitely be beneficial but the number one thing is to go see your doctor asap and make sure there is nothing else more serious going on.

Then you can develop a migraine management plan with him/her and get your life back.


These Can Help Stop The Debilitating Nausea

I get nausea and dizziness with each and every one of my migraine attacks. I use anti-nausea bands and some essential oils to help calm me down.

These work for me:

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Vestibular Migraine Sources:
1. VEDA (2018) Vestibular Migraine (A.K.A. Migraine Associated Vertigo or MAV). Available [online] at:  Accessed Oct. 23, 2018 Updated Dec. 2018.

2. John Hopkins Medical (2018) Conditions We Treat: Vestibular Migraine. Available [online] at: