What is vestibular migraine?

Vestibular migraine (VM) is a neurological condition that causes both migraine headaches and vestibular symptoms, primarily dizziness and balance problems. It's important to remember that not everyone with VM experiences a headache with every episode. Some people may only experience the vestibular symptoms.

The Vestibular System: The vestibular system includes the inner ear and brain areas that process sensory information involved in controlling balance and eye movements. Problems in this system can lead to dizziness, vertigo, and imbalance.

Migraine and the Brain: Migraine is a complex neurological disorder that involves changes in brain activity and blood flow. It can trigger a variety of symptoms, including headache, nausea, sensitivity to light and sound, and, in the case of vestibular migraine, vestibular disturbances.

Recognising the symptoms

Vestibular migraine symptoms can vary greatly from person to person. You might experience one or more of the following:

  • Vertigo: A spinning sensation, either you are spinning, or the room is spinning around you.
  • Dizziness: A feeling of unsteadiness, light headedness, or disorientation.
  • Imbalance: Difficulty maintaining balance, feeling wobbly.
  • Nausea and vomiting: Often accompanying dizziness or vertigo.
  • Headache: May be present, but not always. Can range from mild to severe.
  • Sensitivity to motion: Feeling sick or dizzy with movement (e.g. car rides).
  • Visual disturbances: Blurred vision, sensitivity to light (photophobia), or visual aura.
  • Cognitive difficulties: Trouble concentrating, memory problems, brain fog.

Identifying your triggers

Identifying triggers for VM is an important step in managing symptoms and can help reduce how often symptoms appear. Common triggers include:

  • Stress/anxiety
  • Sleep disruption
  • Missed meal/dehydration
  • Certain foods and drinks
  • Bright or flickering lights
  • Hormone fluctuations
  • Weather changes
  • And more...!

Treatment options

While there is no cure for vestibular migraine, various treatments can help manage symptoms and improve your quality of life. The most beneficial way to treat it is usually through a combination of lifestyle modifications, vestibular rehabilitation and medications. Beginning with identifying and addressing your triggers is a good place to start.

Lifestyle modifications:

  • Dietary changes: Identifying and avoiding migraine triggers (e.g., aged cheese, chocolate, caffeine, alcohol). Avoid food and drinks that have a high salt or sugar content. A Mediterranean style diet has been shown to be beneficial in the management of migraine attacks
  • Eat regular meals. Fasting is best to be avoided
  • Drink adequate amounts of fluid daily
  • Stress management: Practicing relaxation techniques like yoga, meditation, or deep breathing
  • Box breathing: imagine a box, breathe in for 4 seconds along the top of the box, hold your breath for 4 seconds going down the side of the box, breathe out for 4 seconds along the bottom of the box, hold for 4 seconds going up the side of the box
  • Grounding: Name 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell and one thing you can taste
  • Regular exercise: Engaging in moderate physical activity can help reduce stress and improve overall health
  • Vestibular Rehabilitation Therapy (VRT): Vestibular rehabilitation has shown to be beneficial in reducing symptoms of dizziness and imbalance. This must be individually tailored to work on your specifics requirements and prescribed at a level that will not exacerbate your symptoms to trigger an attack. Exercises may focus on eye movements, gaze stability, balance, gait training, habituation to triggering movements and motion sensitivity.  If you have been prescribed an individual exercise programme, please follow this as instructed and liaise with your physiotherapist for further advice if needed
  • Adequate sleep: Aim for 7-8 hours of quality sleep per night
  • Keep a regular sleep routine (going to bed and waking up at the same time) even on weekends and holidays
  • Turn off bright lights or electronic devices at least 30-60 minutes before bedtime
  • Aim for a minimum of 20 minutes of sunlight exposure during the day
  • Supplements: Always consult your GP before starting any supplements. Some people find relief with supplements to reduce symptoms. Research suggests the following are the most effective:
    • Magnesium glycinate: 400-600mg per day
    • Riboflavin (vitamin B2): 400mg per day
    • CoQ10: 100-300mg per day
    • Ginger: ¼ of a teaspoon or as per guidelines if capsules
  • Light Sensitivity: Special light filtering glasses can help reduce migraine frequency and intensity. Please see examples below:
    • FL-41 rose-tinted lenses filter blue/green light - a reasonably priced brand on Amazon are Braddell
    • Newer lenses (e.g., Avulux) block wider wavelengths, reduce symptoms with less colour distortion. This brand is more expensive but have more styles and lenses are less tinted.
  • Screens/devices: If you need to use computers, laptops or other screens regularly, using the above glasses can help reduce them triggering your symptoms. Also try to adopt the 20:20:20 rule - every 20 minutes look into the distance 20 feet for 20 seconds.
  • Medications:
    • Migraine preventatives: Beta-blockers, antidepressants, calcitonin gene-related peptide inhibitors (CGRP) and anti-seizure medications can help reduce the frequency and severity of migraine attacks.
    • Acute migraine medications: Triptans and NSAIDs (ibuprofen) can be used to treat headache pain during an attack.
    • Vestibular suppressants: Antihistamines and antiemetics can help relieve dizziness and nausea but should only be used for a short period of time because they are a vestibular suppressant and may inhibit recovery in the longer-term

Further resources

Here are some useful websites to find out more information about vestibular migraine:

 

Below are some useful Instagram accounts and podcasts to follow for advice and education:

  • Balancing Act Rehab (Podcast: Talk Dizzy To Me)
  • The Dizzy Cook - Alicia Wolf
  • The Vertigo Doctor - Madison Oak (Podcast: Grounded: The Vestibular Podcast)
  • Allinyourheadpt- Sonia Vovan
  • Dr Emily Kostelnik
  • Migrainedoc - Katy Munro
  • Heads UP podcast

 

Additional information:

First Community provides front-line NHS community healthcare services in east Surrey and parts of West Sussex.

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us:

First Community (Head Office)

Call: 01737 775450 Email:  fchc.enquiries@nhs.net   Text: 07814 639034

Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.

 

For office use only: Version 1 PFD_LTC053 Published: February 2026