Severe and Acute Migraines: Coping with Vertigo and Nausea

Medically reviewed by Deborah Weatherspoon, PhD, RN, CRNA on November 28, 2017Written by Lindsey Konkel

Overview

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

Migraine-associated vertigo (MAV) is dizziness and unsteadiness that comes with a migraine. About 40 percent of people with migraines have experienced some kind of dizziness or disruption in their balance during an attack, according to the Vestibular Disorders Association. This condition is sometimes called migrainous vertigo.

Symptoms of migraine-associated vertigo

MAV 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 occur.

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

Ways to manage vertigo

In general, drugs used to treat migraine pain don’t help with vertigo. This includes triptans. Drugs made to counter normal episodes of vertigo and nausea may be helpful for MAV symptoms. These drugs include:

  • dimenhydrinate (Dramamine, Gravol)
  • meclizine hydrochloride (Antivert, Dramamine Less Drowsy)

If your episodes are debilitating or frequent, your doctor may recommend a preventive medication regimen. High blood pressure, seizure, or antidepressant medications can help eliminate MAV. 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 migraines to chronic migraine. Someone with chronic migraine has a migraine 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 migraines. Together you 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. Read on for other ways to reduce nausea.

Antiemetics, or antinausea medications, can help reduce nausea or vomiting. Some over-the-counter (OTC) antihistamines may be used to treat nausea associated with vertigo or dizziness. They include dimenhydrinate and meclizine hydrochloride.

If you’re taking other prescription medications, talk to your doctor before using an OTC antiemetic.

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

Migraine and nausea in children

About 10 percent of school-age children have had a migraine, according to the Migraine Research Foundation. 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 are very common in children who have migraines. In fact, this common condition can occur without a migraine. It’s referred to as a migraine equivalent.

Other non-migraine symptoms children with migraines might experience include:

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

General OTC pain medications, including acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve), may help relieve abdominal symptoms. Stronger antiemetics may also be prescribed by your child’s doctor.

When to see a doctor

Speak with your doctor or your child’s doctor about appropriate treatments if you think you or your child are experiencing vertigo or nausea with your migraines. They can help you form a treatment plan to manage your symptoms.

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