Monday, May 13, 2013

Migraine-associated Dizziness

The most common cause of dizziness overall is migraine. The most recent research data indicate that approximately 60-80% of all patients reporting dizziness, in particular without hearing loss, have migraine-associated dizziness.

Migraine-associated dizziness is one of the most under recognized conditions in medicine today. It can occur at any age and dizzy symptoms may occur before, during and/or after migraine pain, or may occur without headache pain at all. Therefore, some people who have had a history of migraines but no longer have the headache pain of migraine, may still have dizziness from the same underlying cause. One very common story that we hear is that someone used to have migraines years or even decades ago, but no longer has headaches at all, and is now experiencing dizziness, attacks of vertigo and/or disequilibrium. Approximately 90% of those who claim to have “sinus” headaches are actually suffering from migraine, in particular if they notice headache and/ or dizzy symptoms associated with change in weather or other identifiable triggers.

Common symptoms of migraine-associated dizziness:

  • Sense of lightheadedness and imbalance, typically worse in the morning Sensation of floating and that the head and eyes are not moving together
  • Visual motion or activities that require visual stimulation can be particularly bothersome
  • Light and/or noise sensitivity may be present
  • Looking for items at the grocery store or being in large, open buildings is often difficult
  • Feeling dizzy or off balance with walking, bending over or with quick head turns

Diagnosis of migraine-associated dizziness is usually made after ruling out other causes of dizziness such as BPPV, Meniere’s disease, or vestibular neuritis.

Treatment for this common cause of dizziness requires elimination of any trigger factors that might be exacerbating migraine symptoms, such as dietary triggers, skipping meals, stress, inadequate sleep, use of nicotine, etc. Often, medications that prevent migraines are prescribed. Physical Therapy/Vestibular Rehabilitation Therapy can help with balance issues and motion sensitivity once the headaches are under control. 

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