A neurological disorder known as vestibular migraine is frequently misdiagnosed and can lead to disabling dizziness and balance issues in millions of adults, experts warn.
Vestibular migraine occurs when nerve cells in the brain misfire, similar to a typical migraine, but without the characteristic throbbing headache. Instead, individuals experience severe bouts of vertigo, dizziness, and imbalance. These episodes can last from five minutes to an hour and may be accompanied by nausea, sensitivity to light and sound, and motion sickness.
Because head pain is absent, doctors may mistakenly attribute the symptoms to other conditions such as benign paroxysmal positional vertigo, an inner-ear issue caused by dislodged crystals. A 2018 study indicated that only about 10% of individuals with vestibular migraine receive a correct diagnosis.
Dr. Diego Kaski, a consultant neurologist at University College London, noted that a lack of recognition among both patients and medical professionals contributes to the underdiagnosis. He stated that many people may suffer from what they believe are mere dizzy spells for years without knowing that simple interventions can help reduce their frequency.
There are no specific diagnostic tests like blood work or brain scans for vestibular migraine. Diagnosis typically involves ruling out other potential causes.
Certain factors can increase the likelihood of developing vestibular migraine. Individuals with a history of headaches are considered at higher risk if they present with dizzy spells. The condition is also more common in women. A strong predictor is experiencing motion sickness, such as when reading in a car, which can make a person 17 times more likely to develop vestibular migraine.
Craig Hogan, a 47-year-old finance worker from Preston, England, experienced his first dizzy spell before the COVID-19 pandemic. While trying to stand up from his sofa, he felt an intense sensation of his head spinning and ended up on his hands and knees. Initially diagnosed with labyrinthitis, an inner-ear inflammation, Hogan's dizzy spells increased in frequency over several years, becoming debilitating and affecting his ability to work or leave his home.
He eventually received a diagnosis of vestibular migraine and found that lifestyle adjustments significantly improved his condition. Research suggests that a diet low in processed foods and artificial sweeteners can reduce attack frequency. Regular exercise may also help by reducing brain inflammation and making the nervous system less reactive. Establishing a consistent routine, including regular sleep and meal times, is also crucial for managing migraines.
Newer medications, such as calcitonin gene-related peptide inhibitors, have shown promise in early trials for vestibular migraine, though for Hogan, understanding the cause and making lifestyle changes proved transformative.