A neurological condition known as vestibular migraine, often overlooked by medical professionals and sufferers alike, is believed to be a common cause of chronic dizziness and vertigo. Unlike traditional migraines that typically involve severe headaches, vestibular migraine's primary symptom is disorientation, which can lead to misdiagnosis as other conditions such as inner-ear disorders.
Health service data often attributes dizziness to inner-ear issues, low blood pressure, or medication side effects. However, experts suggest that a significant number of individuals experiencing persistent dizziness may actually be dealing with vestibular migraine. This condition arises when nerve cells in the brain misfire, similar to a standard migraine, but without the characteristic headache. Instead, symptoms can include intense vertigo, imbalance, nausea, sensitivity to light and sound, and motion sickness, with episodes lasting from minutes to an hour.
This lack of typical migraine pain leads many doctors to overlook the possibility of a migraine disorder, instead diagnosing conditions like benign paroxysmal positional vertigo (BPPV). A 2018 study indicated that only about 10% of individuals with vestibular migraine received an accurate diagnosis. The condition is estimated to affect one in 100 people in the UK, though experts believe this figure is likely a substantial underestimate, with many living with the disorder for years without recognition.
Dr. Diego Kaski, a consultant neurologist at University College London, highlighted the lack of awareness among both patients and doctors as a primary reason for underdiagnosis. He stated that many individuals suffer for years, unaware that simple management strategies could alleviate their symptoms.
Diagnosing vestibular migraine typically involves ruling out other potential causes, as there are no specific blood tests or brain scans for it. However, certain indicators can suggest the condition. Dr. Kaski noted that a history of headaches in patients complaining of dizziness should raise suspicion. Women are also more prone to developing vestibular migraine than men. A strong predictor is motion sickness, particularly when reading in a moving vehicle; individuals experiencing this are significantly more likely to develop vestibular migraine.
Craig Hogan, a 47-year-old finance worker, experienced his first debilitating dizzy spell before the pandemic. Initially diagnosed with labyrinthitis, an inner-ear inflammation, his spells became increasingly frequent, affecting his ability to work and leave his home. After seeking private medical help due to long NHS waiting times, Hogan was diagnosed with vestibular migraine. He reports that implementing diet, exercise, and lifestyle changes has led to a significant reduction in his dizzy spells.
Research suggests that dietary adjustments, such as reducing processed foods and artificial sweeteners, can help manage vestibular migraine. Regular exercise is also beneficial, potentially reducing brain inflammation and increasing the nervous system's resilience to movement. Maintaining a consistent daily routine, including regular sleep patterns and meal times, is also crucial, as the brain affected by migraines benefits from regularity. Newer treatments, such as CGRP inhibitors, are showing promise in trials but require specialist prescription. For Hogan, understanding the cause of his symptoms and adopting a healthier lifestyle transformed his quality of life.