Vestibular migraine is a type of headache disorder characterized by symptoms such as dizziness, vertigo, and sensitivity to light and sound. The term “vestibular” generally refers to the system in your inner ear responsible for your body’s balance.

According to the World Health Organization (WHO), headache disorders are one of the most common nervous system conditions. They affect roughly 50 percent of all adults worldwide.

Doctors aren’t entirely sure what causes people to develop vestibular migraine. Much of the knowledge about diagnosis, triggers, and treatment stems from research that doesn’t focus specifically on this condition.

However, according to a 2017 review of scientific literature, research has suggested that top vestibular migraine triggers are:

  • certain foods
  • sleep concerns
  • hormonal changes

This article explores potential triggers of vestibular migraine, as well as how to relieve symptoms and when to seek medical attention.

Certain foods have been known to trigger migraine. These are believed to trigger vestibular migraine, too.

According to a 2020 research review, some common migraine trigger foods include:

  • alcohol
  • aspartame
  • caffeine
  • cheese
  • chocolate
  • citrus fruits
  • coffee
  • dairy
  • foods high in fat
  • foods with yeast
  • monosodium glutamate (MSG)
  • nuts
  • processed meats

Certain compounds in these foods, such as the phenolic (aromatic) compounds in fruits and alcohol, may play a role in migraine. Many of these compounds interact with different pathways in the brain involved in the development of a migraine episode.

Yet, the relationship between food triggers and migraine isn’t entirely understood and more research is needed.

Hormonal shifts, such as those that occur during menstruation or hormone therapy, are one of the most common triggers of both migraine and vestibular migraine specifically.

In 2007, one of the largest studies on migraine suggested that hormones acted as a trigger for about 65 percent of study participants. However, it’s important to note that these findings were based on participant self-reporting.

Estrogen is the hormone primarily associated with migraine. According to 2021 research, both the rise and fall of estrogen are associated with migraine development.

When estrogen levels increase or decrease, it can cause changes in blood pressure and inflammatory markers, both of which are thought to trigger migraine attacks.

A wide variety of factors can cause psychological stress. You may experience both minor and major sources of stress, such as:

  • injuries or accidents
  • physical or mental health conditions
  • loss

Stress is a well-known trigger for both migraine and vestibular migraine. In fact, in the 2007 study mentioned above, almost 80 percent of study participants cited stress as a trigger for migraine symptoms.

According to the National Health Service (NHS), stress is believed to trigger migraine through the activation of various pathways in the brain. This involves certain chemicals, nerves, and blood vessels.

When stress activates the hypothalamus, these pathways are activated along with other areas of the brain — and this can trigger migraine.

Sleep disturbances can include difficulty falling and staying asleep as well as poor sleep quality. These are a vestibular migraine trigger.

According to a 2019 study, people who experience vestibular migraine have poorer sleep quality. This, in turn, can trigger more migraine episodes.

Researchers believe that poor sleep can contribute to migraine development by activating the hypothalamus and the amygdala, both of which cause brain changes associated with migraine.

Over the long term, the impact of stress on your brain can also lead to changes that coincide with increased migraine frequency.

Certain medications, especially those that alter hormone levels or affect blood vessel dilation, may trigger vestibular migraine as a side effect. In addition, some medications may be more likely to cause vestibular migraine if they’re taken too frequently.

Medications that may trigger vestibular migraine headaches include:

  • analgesics
  • antidepressants
  • combination pain relievers
  • ergotamine
  • hormone replacement therapy
  • opioids
  • oral contraceptives
  • triptans

Research on the link between medication use and vestibular migraine is limited, so more studies are needed.

Weather changes, such as in barometric (or atmospheric) pressure or temperature, are a potential cause of vestibular migraine.

Typically, barometric pressure undergoes minor shifts throughout the day. However, it can also rise and fall dramatically depending on current weather patterns.

According to a 2021 review, two studies associated drastic changes in atmospheric pressure with migraine episodes. In addition, certain weather patterns can affect the atmosphere’s atomic makeup, which may impact various levels of chemicals in the brain associated with migraine.

Based on a self-reported study from 2019, hot and humid weather is also associated with migraine attacks.

Light changes, especially those involving bright or flashing lights, are another well-known migraine trigger.

According to the 2007 study mentioned above, roughly 38 percent of participants cited light as a migraine trigger — which makes it a potential vestibular migraine trigger as well.

Based on a 2017 study, researchers believe that, in addition to being a migraine trigger, light may impact how severe your migraine symptoms are.

According to the above research on the subject, this is likely due to the connection between neurons in your eyes and pathways in your brain that are associated with migraine symptoms.

Although vestibular migraine falls under the general category of “migraine,” it doesn’t always cause the headache that’s typically associated with migraine. That said, some people with vestibular migraine may experience a severe throbbing headache.

Vestibular migraine is more often characterized by symptoms in your vestibular system along with other migraine symptoms such as sensitivity to light and sound.

Symptoms of vestibular migraine vary from person to person but may include:

  • nausea and vomiting
  • dizziness
  • loss of balance
  • sensitivity to light, sound, or smell
  • vertigo triggered by motion

According to the current diagnostic criteria, a diagnosis of vestibular migraine requires at least 5 episodes with vestibular symptoms, lasting anywhere from 5 minutes to 72 hours.

Research is still ongoing on the effectiveness of treatment options for vestibular migraine. However, according to a 2020 research review, current treatment recommendations involve several different approaches:

  • Dietary modifications and behavioral changes. One of the first steps in managing vestibular migraine is to reduce exposure to triggers. Keeping a symptom journal can help you identify your triggers more easily so that you can avoid them. If your symptoms are primarily triggered by diet, you’ll want to eliminate any trigger foods from your diet. If your triggers include lifestyle factors, such as poor sleep, try to take steps to improve these areas of your life.
  • Medications to control symptoms during episodes. It’s not always possible to prevent vestibular migraine. Medication can help during an episode. Medication options may include triptans, over-the-counter pain medications, steroids, and antiemetic drugs. Most of these medications function by reducing the common symptoms of these types of migraine episodes, such as dizziness, motion sickness, and nausea.
  • Prophylactic medications to prevent future episodes. Prophylactic (preventive) medications are considered one of the most effective treatment options for vestibular migraine. These may include beta-blockers, valproic acid, topiramate, tricyclic antidepressants, and lamotrigine. Venlafaxine and flunarizine have also been shown to be effective for vestibular migraine prophylaxis.
  • Complementary treatments. Vestibular therapy performed by a physical therapist has been shown to be effective for vestibular migraine, according to a 2018 research review. Acupuncture and neural stimulation may also be helpful, according to a 2020 review and a 2019 study, respectively.

As always, treatment for a condition like vestibular migraine may differ for each person. Reach out to a healthcare professional to discuss the best treatment options for you.

If you’ve been experiencing symptoms of vestibular migraine, schedule an appointment with a doctor as soon as possible for a diagnosis. A primary physician is a good first point of contact.

They may refer you to a neurologist for more in-depth examination and treatment. Neurologists specialize in conditions that cause complications with your senses, such as touch, vision, smell, or balance.

Since vestibular migraine can significantly impact your quality of life, early diagnosis and treatment is important.

If a doctor or neurologist has diagnosed your condition as vestibular migraine, they can prescribe medications to help ease your symptoms during episodes.

You’ll likely be asked to keep a log of any migraine triggers you notice so that you can avoid them. In many cases, a doctor can also prescribe preventive medications to prevent future migraine episodes.

While a vestibular migraine is not generally considered dangerous, you should seek medical attention right away if you experience any of the following:

  • a headache that doesn’t improve or quickly gets worse
  • neck stiffness
  • high fever
  • muscle weakness
  • speech or vision changes
  • numbness or tingling
  • confusion or decreased awareness
  • convulsions

Vestibular migraine is a type of migraine. It’s characterized by vestibular symptoms, such as dizziness and vertigo, in addition to classic migraine symptoms.

A vestibular migraine can be caused by any number of triggers — from certain foods to hormonal changes. Treatment for vestibular migraine generally involves:

  • dietary changes
  • lifestyle modifications
  • medications for symptoms and prevention

If you’ve been experiencing symptoms of vestibular migraine, try keeping a journal of personal triggers. This way, you can take it to a healthcare professional to help them diagnose and treat the condition.