VESTIBULAR MIGRAINE

Migraine is one of the most debilitating chronic disorders. It is almost as prevalent as hypertension (high blood pressure) and is more common than asthma and diabetes. More importantly, migraine strikes people during what are expected to be their most productive years: between ages 20 and 40 for most women, with a slightly higher age range for men.

Despite better diagnostic capabilities and efforts to improve public awareness and education, it is estimated that approximately 50% of migraineurs go undiagnosed or mismanaged to this day.

Often described as “sick headache,” migraine is typically characterised by unilateral onset of head pain, severe progressive intensity of pain, throbbing or pounding, and interference with the person’s routine activities. Accompanying symptoms of photophobia (sensitivity to light) or phonosensitivity (intolerance to noise), as well as nausea and/or vomiting, are common, and often leads to the inability to perform daily tasks.

Most people associate migraine with severe head pain and a period of inability to do anything. However, a large portion of people with migraine often have no accompanying pain. Instead, their predominant symptom is vertigo (a spinning sensation). This may also be described as dizziness/ disequilibrium (balance loss), mental confusion, disorientation, dysarthria (difficult with speech), changes to their vision, or hand/feet weakness. This presentation may result in a visit to the Doctors and extensive laboratory, imaging, and other diagnostic evaluations—often with normal results, which lead to increased confusion and anxiety on the part of the patient. In addition, anti-emetic (anti-vomiting) medications are often given, which may have sedative side effects associated with increased postural instability and increased fall risks.