Migraine-Associated Dizziness

What Is a Migraine?

A migraine is more than simply a bad headache. It is both a chemical and electrical event in the brain. While headache is the best-known characteristic, these disturbances also may produce a variety of other symptoms. The symptom experienced depends on the part of the brain where the migraine occurs. Dizziness due to migraine is called migraine-associated dizziness (MAD).

What Are the Symptoms of Migraine?

When experienced in the back of the brain or occipital lobe, a migraine results in spots or flashing lights in the visual field. In other parts of the brain they can cause numbness or tingling of any part of the body. In the cerebellum or brainstem, a migraine can cause vertigo and nausea. There may or may not be a headache following any of these symptoms.

How Did I Get a Migraine in the First Place?

There are many triggers for migraine. Bright lights or loud sounds may be triggers. Stress and sleep deprivation lower the threshold for symptoms in migraine patients. The smell of strong perfumes and chemicals can be enough to set a patient off. Consuming chocolate, caffeine, wine, and many processed foods can increase the chance of a migraine.

How Does the Dizziness of Migraine Feel?

The perception of dizziness is difficult to describe for patients experiencing MAD. It is typically a less severe sensation than other forms of vertigo. However, it lasts longer and may be constant for many days at a time. Some patients describe feeling of dropping in an elevator. Others feel like they are rocking on the deck of a boat. Some cannot focus on a screen or a book. Occasionally patients can only say they feel “off”.

How Will My Doctor Test for MAD?

The evaluation starts when a patient tells their doctor that they feel dizzy. A description of dizziness like that of MAD and a history of migraine is suggestive of the diagnosis. A hearing test will usually reveal normal hearing. Testing of the balance system or VNG will usually be normal, however, it may be more uncomfortable to migraine patients than others. If an MRI of the brain is obtained, it may be normal or show nonspecific signs of migraine. Essentially, MAD is diagnosed when another cause of dizziness is not found and symptoms are suggestive of migraine.

Is MAD Treatable?

If you know what triggers your symptoms and can avoid it, this may be all you need to treat migraine. Also, improving your sleep hygiene and decreasing stress levels are likely to improve your health in many ways beyond just improving dizziness.

If these simple steps do not help, you should consider searching your diet for triggers. The more common triggers are listed previously, but comprehensive lists are available in your doctor’s office and online.

If you have tried all these and you continue to suffer, medications should be considered. Typical treatments for migraine include daily medications to prevent migraine and as needed medications to stop a migraine. Only the preventative medications help with MAD. The medications that are used are typically used to treat seizures, depression, and high blood pressure but have been found to help migraine as well. If you have high blood pressure and migraine, propranolol is a good medication for you. If you have anxiety, depression, or insomnia with migraine, nortryptilline or amitryptilline can help. If you have seizures or cannot tolerate the side effects of other medications, topiramate may be the right choice for you.