Along with throbbing pain and sensitivity to light and sound, severe and acute migraines can also cause vertigo and nausea.

Migraine-Associated Vertigo

Migraine-associated vertigo, sometimes called migrainous vertigo, is dizziness and unsteadiness that comes with a migraine. About 40 percent of those with migraines have experienced some kind of dizziness or disruption in their balance during an attack.

Migraine-associated vertigo is often described as a sense of rotational movement, or feeling like the room is spinning. Feelings of general unsteadiness, imbalance, or motion sickness can also happen.

These sensations can last anywhere from a few minutes to a few days. Symptoms may occur before, during, or in the absence of a headache.

Ways to Manage Vertigo

In general, drugs used to treat migraine pain, including triptans, don’t help with vertigo. Drugs made to counter normal episodes of vertigo and nausea may be helpful for migraine-associated vertigo symptoms. These drugs include dimenhydrinate (Dramamine, Gravol) or meclizine hydrochloride (Bonine, Antivert, Postafen, Sea Legs, Dramamine Less Drowsy).

If your episodes are debilitating or frequent, your doctor may recommend a preventative medication regimen. High blood pressure, seizure, or antidepressant medications can help eliminate migraine-associated vertigo. Avoiding known migraine triggers and making sure you get enough sleep may also help.

Migraine with Nausea

Severe or acute migraines can also cause nausea or vomiting. Women tend to experience these symptoms more often than men.

A 2014 study found that people who experience frequent, persistent nausea with a migraine are twice as likely to progress from episodic or infrequent migraine headaches to chronic migraine. Someone with chronic migraine has a headache on more than 15 days per month.

Some migraine-specific medications, especially ergotamines, may cause abdominal side effects such as nausea and vomiting. It’s important to tell your doctor if you’re having bouts of nausea along with your headaches. You and your doctor can discuss different treatment plans.

Ways to Manage Nausea

If you feel a migraine coming on, staying in a quiet dark room and sipping water may help reduce nausea.

Antiemetics, or anti-nausea medications, can help reduce nausea or vomiting. Some over-the-counter antihistamines, including dimenhydrinate (Dramamine) and meclizine hydrochloride (Dramamine Less Drowsy), may be used to treat nausea associated with vertigo or dizziness.

If you’re taking other prescription medicines, talk to your doctor before taking an over-the-counter antiemetic.

Prescription anti-nausea medications such as metoclopramide may also be used to treat more severe cases of nausea associated with migraine. Metaclopramide (Reglan) can be taken orally in a pill form or administered intravenously.

Migraine and Nausea in Children

About 10 percent of school age children have had a migraine. Children with migraines tend to experience symptoms differently than adults with migraines. For example, head pain may be less severe than other symptoms, including nausea.

Abdominal pain and vomiting occurs in about 90 percent of children who have migraines.

Other non-headache symptoms children with migraines might experience, include:

  • attacks of stomach pain or cramping
  • sensitivity to light or sound
  • dizziness
  • mood changes

General pain medications available over-the-counter, including acetaminophen (Tylenol), ibuprofen (Advil), and naproxen sodium (Aleve), may help relieve abdominal symptoms. Stronger antiemetics may also be prescribed.

Speak with your doctor about appropriate treatments if you think you or your child are experiencing vertigo and/or nausea with your migraines.

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Break It Down: Migraine and Severe Migraine

Migraines are intense headaches that affect more than one in 10 people. Women are three times more likely to experience migraines than are men, and migraines have been shown to run in families.

These painful headaches can last up to 3 days if not treated, causing throbbing pain, sensitivity to light or sound, nausea and vomiting, and difficulty doing normal physical activities, such as standing or walking. Severe migraines can also cause symptoms like uncomfortable tingling or weakness in your arms and legs, or even vision changes such as seeing flashing lights or blurring. Vision changes, odd sensations of smell, or feeling unwell may precede a migraine in what is known as the aura. Auras typically begin slowly over five to 20 minutes and usually cease within 60 minutes.

While rare, other types of migraines can cause partial blindness, double vision, paralysis on one side of the body, vertigo, or symptoms that may mimic a stroke. Migraines can become so severe and disruptive that they require treatment in the emergency department. If you experience speech, vision, or balance problems you haven’t experienced before, you should be seen by a qualified medical professional. Persons over the age of 50 should seek medical attention if what appears to be a migraine starts suddenly, like a clap of thunder, because this presentation could be a sign of something more serious.

You should know that certain factors can trigger migraines. These include physical or emotional stress, bright lights and sounds, strong odors, changes in the weather, cigarette smoking, drinking alcohol, not getting enough sleep or food, and certain foods and food additives. Women experiencing hormone changes during menopause may also begin to experience migraines for the first time.

If you begin to experience a severe migraine, resting in a quiet, dark room might help. Several over-the-counter medicines, such as ibuprofen or naproxen, may help relieve the symptoms and severity of migraines.

Your doctor may prescribe special medications to treat migraines. Triptans comprise the class of drugs most commonly prescribed for severe migraines. Other types of medications, including antidepressants, cardiovascular drugs, and anti-seizure medications, have been approved to help treat and prevent migraine headaches.

Avoiding known triggers is a logical way to avoid migraines. Other ways to help prevent them include getting adequate sleep, relaxing to relieve stress, and using acupuncture or massage therapy.

Keeping a diary of your headaches, noting events that lead up to them and their severity, and bringing it to your doctor’s appointment can offer clues about how best to treat your migraines.