The Vestibular Disorders Support Community
Read our welcome post, user support wiki & visit our member recommended products page

Aura and vestibular migraine

I am interested in your experience with auras in Vestibular Migraine. I started to have auras about 10 years ago, with the onset of menopause. I usually had one or two auras per year. They slowly increased to monthly and currently, I have between two and four auras a month. The auras manifest themselves by zigzag lines (usually in my right eye) which start very slowly and then become big so that they dominate my vision. They last between five and 45 minutes. I then get a stiff neck, nausea and feel a little dizzy sometimes. These symptoms last for 1-3 days. I have been living with these symptoms, even though they are not comfortable. But they did not impact my life in a big way.

In May this year I had a major vestibular migraine attack which lead to a 4-day hospital stay. Interestingly however, I did not have an aura before this attack. The last aura before the attack was seven days ago. So I am now wondering are auras and vestibular migraine attacks connected with each other? It seems that I get auras, but no major attack. Or I get a major attack, but no auras. I am very interested to hear your experiences about this.

That’s covered in this Topic: Scintillating Scotoma. Lovely new addition!. I didn’t get those until well into the condition.

There’s always been a third category for me: vestibular attack. Which is perhaps not a migraine (it certainly doesn’t feel like one) but in any case is a perception of variably extreme spinning or pulling.

1 Like

I guess that’s going to depend on who answers. Everybody id different and by my understanding even individuals experiences vary. I know at least two people who experience straight migraine not VM but who always experience auras beforehand. So regular and uniform that they know exactly how long it will be before the actual attack hits. Very convenient as it gives them time to get home etc. All very civilised I’ve always thought but they are just two individuals. If I treat my vestibular attacks as ‘migraine’ which the specialists say they are then I must have had at least 20 major bedbound ones that last days/weeks before I’ve ever experienced an aura and to date I’ve had three or thereabouts and that’s in 18 years. Even then they were not of the Scintillating Scotoma type you describe of which🤞So far I’ve only ever had the one following a home-cooked Chinese meal and which is written up here Ocular or retinal migraine. Incorrect title but I’d never experienced anything similar before and didn’t know!

I’ve taken the personal experience option here. But thinking about it if you interrogated some specialists I suspect you’d get a much more complicated answer advocating theory along the lines of vestibular attacks actually being part of the aura and it’s all part of the same thing. The specialists spend hours Discussing this subject and write papers about it. I think they all acknowledge that not every attack comes complete with every phase though. As many MAVers don’t actually develop a headache most on here would already appreciate that.

You will find lots of other references if you use the Search facility. Here’s one example
Eye aura

I have experienced visual aura only about three times. Each time it looks like a boomerang filled with flashing diagonal lines. So far it starts in the upper left corner of my vision and slowly traverses across my field of view until it reaches the lower right. It is accompanied by a narrowing of my vision. It looks much like if you rolled up a piece of wax paper and looked down the tube it has formed. Everything in the middle is relatively clear, while the edges become cloudy and blurry.

When this has happened I get hit with a wave of nausea and I have trouble thinking about what I’m doing or saying. If I was driving, it would almost certainly result in a crash. My thinking is so muddled, that I don’t even realize it’s a migraine attack until the aura is half way across my vision. Oddly, no pain is involved.

My last aura attack was over ten years ago, and until I read this post I had not associated it with my VM/MAV/BPPV.

I am so thrilled to learn that the aura component could be added to the mix of symptoms.

1 Like

Scintillating Scotoma: I had never heard of this term, thanks turnitaround, I always thought it was called “silent migraine”. I’ll research it more closely.

Turnitaround, onandon03 and TexOkie: It is very interesting that you have only experienced one or a few of these scintillating scotomas. I had 17 last year and 13 so far this year. Based on these different experiences, it seems that vestibular migraine and scintillating scotomas are not necessarily connected apart from the fact that both occur in the brain.

My experience that these scintillating scotomas give me neck pain, nausea and some dizziness, led me to conclude they were connected with the vestibular migraine. But clearly, this may or may not be the case.

And yes, TexOkie, driving is a challenge. I only had two scintillating scotomas while I was driving and both times I was about five minutes from home. I was able to drive home, but I would have to stop driving if I was further away.

Vestibular conditions are invariably at least in part neurological conditions because balance processing takes up so much of the brains processing capacity.

As my vestibular dysfunction improved so did my neurological symptoms.

It’s tough to say which way the direction causation is for people but I’m sure mine was vestibular dysfunction lead: I was getting migraines because of problems with my ear. The migraines I experienced became more subtle as my balance improved. Since fully regaining my balance (that I lost for over 3 years) I’ve not had a single migraine (and I no longer take meds). However I have experienced minor relapses of neurological impairment or dysfunction but I would not call those migraines. Calling them aura might also be inappropriate because that would suggest the problem was migraine, but I know it was because my ear was having a flair up. Most recently that was down to the dentist messing with my Eustachian tube whilst examining my jaw which lead to BPPV symptoms and subsequently neurological discomfort.

That is a migraine without the headache which supposedly is me. I had classical episodic vestibular migraine attacks for probably ten years before I developed any headaches and incidentally they all lacked aura too.

Neither would one be indicative of the other. Many people with VM never experience either. I read recently only 25% - or similar figure - ever experience true aura and then again aura presents very differently for some. I’ve only had the one scintillating scotoma and maybe three visual auras total. My visual auras were rather like dancing washing lines of deeply coloured bed sheets and occasionally just sparkling static coloured lights twinkling against a dark background.

I’ve strong feeling if I asked either of my half a dozen true classic type migraineur friends they’d say your description is a migraine.

Btw three of the above always get aura pre-attack and it’s scintillating scotomas type. One other only sometimes gets visual aura and the others don’t get auras at all ever. I don’t recall any of them ever mentioning an aura that didn’t lead on to an attack.

1 Like

Thank you turnitaround and onandon03. I went through some of the posts on this forum and found this very interesting post by Jem:

That’s the very Topic I linked in my first response to you :arrow_up::sweat_smile:. Did you not click on it? :wink:

Yes, I did read part of it. And then I read it again and discovered this great quote.

1 Like

I think it’s a widely accepted explanation that a scintillating scotoma is an electrical disturbance passing through the occipital cortex. Totally harmless but just puts off you continuing your work for a while if you are relying on significant visual acuity to do it: just take a break and enjoy the ride.

We should not dwell on that here because it’s covered in the other Topic. Any further contributions to the subject of Scintillating Scotoma should be added to that Topic.

We don’t want to create low value Topics that duplicate conversations.

” In most patients, vestibular migraine appears in an advanced period of life and often with a temporal delay to the first onset of migraine (10, 17). The association of vestibular symptoms with migraine with aura is controversial, as some studies found this connection (10, 17, 1922), while others discovered that patients with migraine without aura have vestibular symptoms more often or at least equally often as migraine with aura patients (10, 16, 19). In elderly patients, especially in postmenopausal women, the typical migraine attacks are sometimes replaced by isolated episodes of vertigo, dizziness, or transient feeling of disequilibrium (23).”

Extract taken from

3 Likes

That is a fantastic article, thank you Onandon03. Your quote answers my questions perfectly!

2 Likes

Hi all, I thought I would jump in here as auras are something that i wonder about too. I’ve had four in my life described just like yours. One early 20’s (which did freak me out), the second when I was just pregnant with my first child - I didn’t even know yet, and interestingly 18 months ago, I had two in one week. About 6 months after that I started getting this crampy tightening feeling on my scalp. AMD a few months after that, huge vestibular attack.

I’m not sure whether all related, but the migraine activity - all 3 types you mention have ramped up in the last 18 months, but at different times.

Very interesting conversation.

3 Likes

After reading that article, my head is spinning. Not because of an attack, but metaphorically spinning. I’m not sure what I just read.

1 Like

That is clearly similar to what I have been experiencing. Although I have not had any tightening feeling on my scalp. And my auras are much more frequently. Interestingly the article talks about people in an “advanced period of life”, which is the case for me, but definitely not for you.

” Vestibular migraine can occur in any period of life ([10]”??

(https://www.frontiersin.org/articles/10.3389/fneur.2014.00257/full#B10), 14, 15).

I found an interesting article about auras. Here is a link for those of you who are interested: https://www.nature.com/articles/d41586-020-02863-8