Vestibular Migraine- A very common but rarely diagnosed cause of vertigo

Vestibular migraine is the most common central cause of vertigo, but it often goes undiagnosed. Real patient interview demonstrates how to diagnose this disorder.

[PeterJohns]

Just a reminder that I won't give medical advice to individuals about their particular medical problem.

[amberwelch]

I was just diagnosed with this after 6 months of almost constant vertigo. Thankful my doctor was familiar. Hoping to finally start feeling better. Thank you for the very easy to understand video.

[qjuxwct]

I am a patient that was recently diagnosed with vestibular migraines. I’m trying to learn more about how I can stop the effects from lasting so long. Mine last for four days. I’m working with a doctor to test different meds that desire to shorten, the duration and intensity. My EMS background lead me to you video so I could educate myself. During your video, you talked about the fact that nystagmus is very uncommon during a vestibular. I have uncommon nystagmus with my vestibular migraines. During my first vestibular migraine, I was hospitalized, because I had a syncopal episode and was so dizzy I was unable to function. I also had nystagmus that the medical professionals told me was “weird, nothing they had ever seen.” I saw many specialists and I was told “I don’t know what it is.” Thank goodness for another vertigo enthusiast. She told me I have the vestibular migraines that caused PPPD and binocular vision disorder. I am in EMS and I understand the need for case studies. I wouldn’t mind sharing my tests and reports if it will help your clinical journey.

[roseeca]

As a person suffering from chronic vestibular migraines, the diagnosis criteria of 'History of Migraines' is what prevented my diagnosis for 1 year. 1 YEAR of suffering, going to doctor after doctor who had no idea what was wrong with me. All my tests came out normal (VNG, hearing, blood, MRI, etc). Only in month 9 did I experience a visual aura, which is why I myself began wondering if it was vestibular migraines. While I lacked a history of traditional migraines, what I did have is a history of dizzy spells that would last anywhere from a day or two up to a week and a half. I began getting those when I turned 30, and I'd get 2-3/year. Looking back, this information should have led doctors to my diagnosis in a much more timely manner than a year. I even worked with a PT who 'specializes' in vestibular disorders for over 5 months. The diagnostic criteria of a history of traditional migraine is completely unimportant given a history of dizzy spells and no other vestibular loss. I know of many other people with VM who also do not have a history of traditional migraines.

[TheDavethecat]

I have been diagnosed with VM recently. This started last November. I too have the foggy floaty head, mild headaches, nauseous, extreme fatigue and the boat rocking feeling. This is almost on a daily basis. Bbpv was also diagnosed. I have at least one bad episode every fortnight. The last physiotherapist I saw recommended vitamin b2 and magnesium. There is a little light at the end of the tunnel as there is slight improvement. I also do head exercises daily which involves focusing on an object on the wall moving my head from side to side and up and down but not moving my eyes. Hard work but persevering as I want my life back. Hope this helps.

[michelleslifeonrepeat]

It is nice to hear clarity on this subject. As a chronic migraine patient who gets Hemiplegic migraines, migraines with auras, occipital neuralgia, vestibular migraines and ocular migraines, I think the nausea and movement sensitivity of the vestibular kind are the most horrific. Ill never forget crawling to the sink to vomit bile, because there was no way to ground my self to walk, was hands down the scariest. And they happen at the worst times, when you are home alone. I earned that day the value of tucking my phone in my shirt to crawl to sink. Oh. I wouldn't wish them on anybody.

[danacooper]

I was just diagnosed with this today! I was referred to a Neurologist. I've never been diagnosed w migraines, but I get borrowing in the back of my head! Thank you for this easy to understand

[seephor]

Thank you for this information. I am on medication for this that has been life changing. I almost got used to feeling the way I was feeling 24/7 until the symptoms went away and a sense of clarity and calm came over me. The best way I can describe this condition for people who have never suffered from it is. Drink half a bottle of whisky, insert hearing aids even though you have no hearing loss so sounds are amplified and sting you, sit on a chair and have a friend spin you a bit, listen to the screeching brakes of a subway train in your head (tinnitus). Now imagine living like this 24/7. Not fun.

[milkjamjuice]

Thanks for the video on this. I’ve having vertigo and motion sickness episodes for about 22 years, and my doctor is finally taking me seriously about it. I’m currently undergoing tests to see if I have VM. Interestingly enough, my mother is an exact textbook case as you described and is also now just getting testing for VM done. When she was younger, she used to have debilitating migraines, which left me to take care of her as a kid, but that was long before a lot of this new info has come out. Anyway, great video, thanks!

[joycekraus]

I am so grateful for this video. Thank you!!! I could just cry, being able to relate to your patient and having an explanation for the misery of Vestibular Migraine is such a relief!!!!

[doug]

I’m a student nurse practitioner and I find your videos fascinating. Definitive and clear. These videos will help me be a more competent provider and will allow me to provide better care for my patients. Thank you so much.

[entwritescode]

Thank you so much for this video. hits all points. ENT in the Philippines, saw a lady in the ER who had almost the same symptoms. First time to encounter a vestibular migraine patient - initially thought it was BPPV. Thank you again for all your educational videos, Dr Johns!

[elvsrbad]

Interesting video to watch. I ended up here because I've had near chronic vertigo for years now without a diagnosis. MRI came back normal, vestibular testing came back normal, etc. Symptoms have typical been too constant for me to understand what my triggers are. Anyway thank you for creating content to help others with vertigo get a diagnosis, I really hope it can help other people not to suffer like I have had to.

[itubebuddy]

Excellent Video! I am a PT and I always ask this question in my detailed exam. However, this is pretty concise and precise information I needed to be sure of possible Vestibular Migraine. Thank you.

[kellyk]

THANK YOU for this! I had 2 ENTs and a vestibular rehab doc all try to tell me that my dizziness was vestibular migraine. They determined this solely on 1. I was dizzy and 2. Had a history of migraines. I went round and round with them until I was so frustrated I switched doctors entirely! This video just confirmed what I've known all along. It's my ear, not my head. Third ENT is putting tubes in my ears in 2 weeks.

[DA-uiuc]

Thank you for this, it has described my symptoms exactly, I have a history of aura without headaches but have been having these dizzy spells for a number of years and have definitely had way more than 5 episodes. I have to go to bed until it passes and can't stand any noise, the dizziness is very intense when I stand and move around, so I just have to lay down until it passes, usually 24 hours. I also have BPPV but I knew these episodes were completely different as I only have BPPV when laying down and turning over in bed. I guess I'm just unlucky to suffer with both but have done for over 30 years.

[timberhaley]

I found this video the other day. I've had what I've described as ocular migraines stemming from light sensitivity since 1993. I began having short vertigo spells in 2009. In 2010 I had a major spell that left me spinning hard for 15 minutes straight. From there I would have them come and go in short spells. First week of January 2012 I had a spell that lasted a month straight. From there I would have spells with some frequency but ultimately tapering off. I have struggled to get a proper diagnosis and struggled even more so for my doctors to take me serious. Since 2012 spells come and go but what I am left with on a day to day basis is loopiness and a constant dull pressure in my head which makes thinking clearly difficult. I realized that windy or humid conditions flare up the instability in my head which is incredibly frustrating. I have experienced a bit of relief through acupuncture but not much else. Seeing your patient in this video is the first time I have felt as if im not alone. I am stuck in a state of caution and I would like to break this cycle. I will read more from you and look at newer videos from you but unfortunately the rest of the medical world is not moving at the same speed when it comes to newer ways of exploring vertigo.

[tonyf]

Most excellent! I plan to use this video for my physical therapy vestibular rehab special interest group. I have seen many patients that fit these criteria and I think the video really boils the differential dx down to a few easy to remember neat and tidy essentials. Please keep these video gems coming!
Tony Friese, PT
Wausau, WI

[YummyMummyKate]

Was diagnosed with VM a year ago, my symptoms have now been ongoing for two years. I suffer with dizziness daily, no medication has ever helped, I've tried 6 different options now and it's taking its toll on my anxiety and mental health.

[kimdecovich]

THANK YOU 🤗 I can’t even begin to tell you how many times I have been misdiagnosed. You just described me in a nutshell! Can you share… what are some of the causes of these migraines? Stress? Barometric pressure? Lights?Plain old luck?