An estimated 20% of Britons experience dizzy spells, with the figure rising to 30% for those over 60. For more than two million adults, chronic dizziness can become a debilitating condition. While inner ear problems, low blood pressure, or certain medications are often cited as causes, experts suggest a significant number of sufferers may have a neurological disorder called vestibular migraine.
Vestibular migraine is described as the "most common disease you've never heard of." It occurs when nerve cells in the brain misfire, similar to a typical migraine, but without the usual throbbing headache. Instead, individuals experience intense episodes of vertigo, dizziness, and imbalance, which can be accompanied by nausea, sensitivity to light and sound, and motion sickness. These episodes can range in duration from five minutes to an hour.
The absence of head pain often leads doctors to misdiagnose the condition, attributing symptoms to other causes of vertigo like benign paroxysmal positional vertigo (BPPV). A 2018 study indicated that only one in ten people with vestibular migraine receive the correct diagnosis.
Experts estimate the condition affects one in 100 people in the UK, but believe this number is likely an underestimate, with many individuals living with undiagnosed symptoms for years. Dr. Diego Kaski, a consultant neurologist at University College London, noted that a lack of recognition among both patients and doctors contributes to underdiagnosis. "A huge number of people will have vestibular migraine and not know it," he said. "But it's a huge pity, as many may be dealing with what they assume are just dizzy spells for years without knowing there are simple ways to reduce them."
Diagnosis typically involves ruling out other conditions, as there are no specific blood tests or brain scans for vestibular migraine. However, certain risk factors can be indicative. Dr. Kaski suggests that patients with a history of headaches who present with dizzy spells should raise a red flag for primary care physicians. Women are also more susceptible to vestibular migraine than men.
A strong predictor of predisposition is experiencing motion sickness, particularly when reading in a car. According to Dr. Kaski, individuals who get motion sickness while reading in the passenger seat are 17 times more likely to develop the condition.
Craig Hogan, a 47-year-old finance worker, experienced his first dizzy spell before the pandemic, which caused him to collapse upon standing. Initially diagnosed with labyrinthitis, an inner ear inflammation, his dizzy spells increased in frequency over several years, impacting his ability to work and leave his home. After seeking private medical help, Hogan was diagnosed with vestibular migraine and reports that his symptoms have since disappeared following lifestyle changes.
Research suggests that dietary adjustments, such as reducing processed foods and artificial sweeteners, can lessen the frequency of vestibular migraine attacks. Regular exercise is also believed to be beneficial by reducing brain inflammation and improving the nervous system's reactivity to movement. Consistency in daily routines, including regular sleep schedules, meal times, and sleep, is crucial for managing migraines. "The migraine brain loves regularity," Dr. Kaski stated. "Getting enough sleep is also really important, as this can lessen pressure on the brain."
Newer treatments, such as calcitonin gene-related peptide (CGRP) inhibitors, have shown promise in early trials for vestibular migraine, though they are typically prescribed by specialists. For many, understanding the cause of their dizziness and implementing lifestyle modifications has proven to be a transformative approach.