When you think of migraine, you probably think of excruciating pain in the form of a pounding headache. But when it comes to vestibular migraine, that’s not always the case.

In fact, you can experience vestibular migraine without realizing you’re dealing with a type of migraine at all. Here’s some of the telltale signs to look for and when to call your doctor.

What is vestibular migraine?

Vestibular migraine’s a neurological condition that can mess with your sense of balance. Unlike other types of migraine that cause severe headaches, this type often comes along with symptoms of vertigo (that uncomfortable feeling that the ground’s moving beneath you even though you’re standing still).

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Vestibular migraine affects a person’s sense of balance. According to the American Migraine Foundation, it’s the second most common cause of vertigo in adults.

Symptoms include:

Vestibular migraine attacks don’t typically come with a headache. That doesn’t mean vestibular migraine can’t cause a headache, though. They can involve other common migraine symptoms, like headache, nausea, vomiting, and sensitivity to light, smell, and noise.

Research shows that this type of migraine can affect 1 to 3 percent of the population. These types of attacks can be short or last for hours. You could experience random vertigo or extreme sensitivity to light.

There’s still a lot that doctors don’t know about vestibular migraine, but there are some things that seem to be more likely to bring on attacks. These include:

Risk factors

Research has also found that middle aged females are more likely experience vestibular migraine than males. People who experience migraine are also more likely to experience vestibular migraine.

  • Genetics. One study found that genetics can play a role in developing vestibular migraine.
  • Age and sex. Studies suggest women (especially after going through puberty) are more likely to experience migraine.
  • Inner ear disorders. Conditions like Meniere disease and benign paroxysmal positional vertigo may come along with vestibular migraine.

Vestibular migraine episodes can be caused by the same things that cause other types of migraine. Aside from lack of sleep, dehydration, stress, and hormonal fluctuations, triggers can include foods such as:

  • aged cheeses
  • smoked or cured meats
  • excessive caffeine
  • artificial sweeteners
  • alcohols (like red wine, port wine, sherry wine, scotch, gin, and bourbon)
  • chocolate
  • MSG
  • soy sauce or vinegar, or foods that have been pickled or fermented
  • sour cream, yogurt, buttermilk

Make an appointment with your doctor right away if you suspect your dealing with vestibular migraine, especially if it’s affecting your life. They can test for other issues (like hearing loss or high blood pressure) that could be causing your symptoms. Regardless of the cause, your doctor can help you find the best treatment plan for you.

How does diagnosis work?

Diagnosing vestibular migraine can be tricky. Folks can experience a broad range of general symptoms that can be confused with other conditions.

Your doctor will start with a physical exam (taking your blood pressure, checking your hearing, etc.) to rule out other potential underlying issues. There’s no specific test for diagnosing a vestibular migraine, but tracking your symptoms and understanding your family history of migraine can help your doctor determine what’s up.

There are some medications that can be prescribed by your doctor to help avoid future vestibular migraine attacks. Preventative medications can include:

  • beta-blockers
  • calcium channel blockers
  • antidepressants
  • anticonvulsants
  • calcitonin gene-related peptide (CGRP) antagonists

Your doctor may also recommend vestibular rehabilitation. That’s a type of physical therapy that trains your brain to desensitize itself to common sensory triggers.

While researchers aren’t sure exactly how to address the underlying cause of vestibular migraine, making certain lifestyle changes might be able to help ease the frequency and severity of your symptoms. Try:

Vestibular migraine doesn’t always present with typical migraine symptoms, like headaches, so it can be tricky to diagnose. It’s one of the most common causes of vertigo. If you experience dizziness and visual auras, talk with your doctor about your symptoms.

Dehydration and hormonal fluctuations, as well as trigger foods like chocolate, alcohol, and certain fruits could make it more likely for you to experience a vestibular migraine attack. Doctors may prescribe medications, but lifestyle changes can also be helpful in preventing and treating vestibular migraine.