Dr. Shin Beh discussed vestibular migraine during a Facebook Live session, emphasizing that it is a type of migraine primarily characterized by dizziness and vertigo. He explained the distinctions between dizziness—feeling disoriented without the sensation of motion—and vertigo, which is the sensation of movement. Besides dizziness and vertigo, vestibular migraine can manifest with a variety of other symptoms, such as sensitivity to light and sound, nausea, vomiting, ear pressure, tinnitus, and various visual disturbances. These symptoms can complicate the diagnosis, as not every instance of dizziness during a migraine indicates vestibular migraine specifically.
The diagnostic criteria for vestibular migraine require the presence of dizziness or vertigo alongside typical migraine features like headache, sensitivity to light, sound, and certain odors. Interestingly, headache is not an essential part of the diagnostic criteria, with some people experiencing mild headaches or none at all. Dr. Beh noted the challenges patients face during diagnosis if physicians are unfamiliar with vestibular migraine, as it often shares symptoms with other conditions such as Meniere’s disease. Understanding the range of symptoms is crucial for both patients and doctors to avoid misdiagnosis.
For treatments, Dr. Beh categorized them into rescue medications, preventive medications, and lifestyle changes. He reiterated that many treatments for vestibular migraines mirror those used for general migraines, including various classes of medications like antidepressants, anti-epileptics, and CGRP inhibitors. Lifestyle modifications, such as stress management and regular sleeping and eating habits, also play a significant role in managing symptoms. Non-pharmacological approaches, including vestibular rehabilitation therapy and various supplements, can further help patients manage their condition.
Dr. Beh addressed the complexities of co-morbidities associated with vestibular migraines, noting that patients may experience additional issues, including anxiety and depression, which are quite common due to the disabling nature of vertigo. He explained that awareness and education surrounding vestibular migraine can empower patients, as most individuals see significant improvement in their symptoms with appropriate treatment. It’s essential for patients and healthcare providers to work closely together to establish a personalized action plan that addresses the unique experiences of each patient.
Lastly, the session highlighted the importance of appropriate diagnosis and treatment for children who experience vestibular migraines. Dr. Beh acknowledged that the management of migraines in children can lag behind adults but emphasized the need for empathetic, safe treatment plans. Pediatric specialists in ENT and neurology can identify and treat vestibular migraine effectively in children. Finally, he encouraged individuals to seek out healthcare providers who understand vestibular migraine better and to advocate for themselves, as many people can lead normal lives with the right intervention.
