How Can My Vertigo be Migraine?

May 3, 2013
Michael Teixido, MD

Joyce looked at Dr. Teixido with profound skepticism. She had been sent to him for an evaluation of vertigo attacks which had become more frequent and which now prevent her from driving. She does not get headaches to speak of; her mother, brother and sister have very severe migraine problems and she has never had anything like theirs, only dull pressure in the back of her head that doesn’t stop her from doing anything and which goes away with ibuprofen. Her dull head pressure never even occurs at the time of her episodes of dizziness. Dr. Teixido placed Joyce on a safe low-dose medication. Six weeks later she was beaming, astonished her dizziness and head pressure had disappeared. She now realizes she was having migraine symptoms without the severe headache and that her symptoms were responding to a medication commonly used for migraine headache.

Joyce’s story is typical: She does not have severe migraine headaches, she has Migrainous Vertigo. Michael Teixido MD is the Director of The Balance and Mobility Center of Christiana Care and sees patients like Joyce every day. “Migrainous Vertigo is the primary cause of dizziness in over half of the cases I see at the center.” says Dr. Teixido. “It sometimes takes time for patients to accept their balance problems could be related to migraine because they have all heard of or know someone with severe migraine headache and they cannot relate their dizziness to severe headaches. What I help them to understand is there are many forms of migraine they have never heard of that are not necessarily associated with severe head pain. These migraineurs get only the vertigo; their headaches may be absent, mild, or years in the past. Fortunately all can be helped with proven migraine therapies that decrease abnormal migraine activity in the brain.”

“Migrainous Vertigo is the primary cause of dizziness in over half of the cases I see at the center.” says Dr. Teixido.

“40% of migraine headache sufferers do get vertigo at some time but it is not always caused by abnormal activity in the brain. The migraine process in and around the brain is also capable of injuring the inner ear itself. This is why vertigo problems from the inner ear like Meniere’s Disease and BPPV(Benign Paroxysmal Positional Vertigo) are three to four times more common in persons with migraine. Meniere’s disease is an injury associated with swelling in the inner ear and BPPV is a kind of injury that causes crystals in the inner ear to become loose. Patients with chronic forms of these inner ear disorders often improve with migraine therapy because the treatment prevents recurring injury to the inner ear.”

“Vertigo problems from the inner ear like Meniere’s Disease and BPPV (Benign Paroxysmal Positional Vertigo) are three to four times more common in persons with migraine.”

Treatment usually involves educating patients about migraine and migraine triggers first. This education helps them to work together with their doctors most effectively. Each patient may be different. One patient may need to improve their diet, another their sleep patterns, another needs stress reduction; others need the right medication. Usually a combination of therapies is necessary and that combination can be unique to each patient. Using both traditional and natural medicines often gives good results.