Migraine headaches that are associated with dizziness /vertigo are known as vestibular migraines, or migrainous vertigo. The term “vestibular” refers to the inner ear where we sense balance. Most commonly dizziness or giddiness produces a sensation that the room is spinning. Vestibular migraines are not uncommon but they can be quite debilitating.
Episodes of vertigo could last for minutes to an hour before a migraine starts and often continues with the headache symptoms. In some cases the vertigo may even last up to 2 hours. Some people who have vestibular migraines will also see changes in their vision like bright or flashing lights, blind spots and visual disturbances. They will also have many of the more common migraine symptoms, like photophobia (unable to tolerate bright light), phonophobia (unable to tolerate loud sounds), severe throbbing head pain, nausea, or vomiting.
Vestibular migraines are treated the same way as any migraine headaches, using anti-inflammatory medications Diclofenac and other analgesics. If there is vertigo vestibular sedative like Cinnarzine should also be given.
There are other vestibular syndromes that can be associated with migraines. Benign Paroxysmal Vertigo and other causes of vertigo must be ruled out by full neurological examination including an MRI scan or 3D CT of inner ear.
Some patients with vestibular migraine suffer from tinnitus (ringing in the ears), but without hearing loss. In children they will have occasional spells of vertigo and imbalance, but no tinnitus or hearing loss.