Migraine is a complex neurological condition affecting 12-15% of people worldwide and is 3 times more common in women. Migraine usually features a unilateral onset of head pain that is throbbing or pounding in nature. They typically last 4-72 hours and get worse with movement or routine activity, leading to significant intereference with a person’s daily life. Visual disturbance or “aura” is experienced by 20% of those with migraine. Vestibular migraine is a type of migraine where people experience a combination of vertigo, dizziness or balance problems with other migraine symptoms. While the migraine headache pain and vestibular symptoms will be present, they do not have to coincide.
The symptoms of Vestibular Migraine include:
Sensitivity to light/sound
Nausea & vomiting
Anxiety & Panic
Visual Disturbances are common with vestibular migraine and can have a profound effect on our ability to do our usual activities and go to work, causing significant psychological distress. Visual disturbances include blurred vision, double vision, and sensitivity to complex visual environments such as supermarket aisles.
Through a comprehensive history and a series of objective tests to determine onset of symptoms, progression over time, aggravating factors, and to assess the deficits of the vestibular system. The objective tests include dynamic balance, oculomotor tests, dynamic visual acuity testing, as well as positional testing to rule out other vestibular disorders. It is common for Vestibular migraine to coexist with other vestibular disorders.
Currently, experts believe the most effective way of managing vestibular migraine is with combination of medication, vestibular rehabilitation, and lifestyle modifications. Physiotherapy will focus on Vestibular Rehabilitation, which can help to reduce symptoms and restore function. Based on objective findings from the exam, your physiotherapist will provide a patient specific program that will address the vestibular deficits that are present. Programs typically include gaze stabilization exercises, VOR exercises, balance/gait training, and habitualisation activities. Vestibular rehabilitation aims to improve coordination/balance by retraining your brain and vestibular system to interpret the signals coming from eyes, inner ear, and entire body.
After the Session:
Your physiotherapist will provide a structured program with exercises to complete at home. Physiotherapy has been shown to help manage the symptoms of vestibular migraine. On average patients will find strategies to manage their symptoms in two to three sessions.