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Severe and Acute Migraines: Coping with Vertigo and Nausea

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.

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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).

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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.

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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.

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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.

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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.

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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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