DNV GL/NIAHO Accredited facility.Vestibular Migraine Treatment Richardson & Dallas, TX
At Eminent Medical Center, our headache and migraine specialists understand the profound impact that vestibular migraines can have on your daily life. These debilitating vestibular migraine episodes of vertigo, dizziness, and balance disturbances can disrupt your routine and diminish your quality of life. Our dedicated team of Richardson, TX migraine specialists is committed to providing comprehensive and personalized options to help you manage and treat vestibular migraines.
Call (469) 910-8800 and discover how Eminent Medical Center can help you find relief with our expert vestibular migraine treatment in the Richardson and Dallas, Texas area.
Treatment for Vestibular Migraine-Associated Vertigo
Treatment for vestibular migraine-associated vertigo, or migrainous vertigo, involves a comprehensive approach to manage and alleviate vertigo symptoms and reduce the frequency of vestibular migraine attacks.
Medications such as beta-blockers, anticonvulsants, and calcium channel blockers are commonly prescribed to prevent vestibular migraine-associated vertigo, while anti-nausea medications and vestibular suppressants can relieve acute vertigo episodes.
Vestibular rehabilitation can help reduce vertigo symptoms associated with vestibular migraines, such as dizziness by retraining the brain to process vestibular signals more effectively.
What is a Vestibular Migraine?
A vestibular migraine is a type of migraine associated with dizziness or vertigo, with some dizzy spells occurring with or without a typical migraine headache. Vestibular migraine headaches are sometimes referred to as migraine-associated vertigo, migrainous vertigo, migraine-related vestibulopathy, or vestibular vertiginous migraine.
The causes of vestibular migraine attacks can include genetic predisposition, hormonal changes, high levels of stress, changes in barometric pressure, dietary factors like caffeine, alcohol, or certain foods, environmental triggers such as bright lights or loud noises, sleep disruptions, sensitivity to motion, and dehydration.
These vestibular migraine attacks can last from a few minutes to several hours. They may be accompanied by other migraine symptoms like sensitivity to light and sound, nausea, and visual disturbances.
Effective management of vestibular migraine symptoms often includes lifestyle changes for avoiding triggers, such as avoiding certain foods, eating regular meals, reducing stress, and maintaining good sleep, as well as physical therapy and medications are key to reducing triggers and alleviating symptoms of vestibular migraines.
Sometimes medications play significant roles in vestibular migraine treatment and other headache attacks. Our vestibular migraine treatment specialists may use NSAIDs or triptans for immediate throbbing headache relief. Other medications for vestibular migraine treatment include beta blockers and certain antidepressants to reduce the severity of dizziness and other migraine symptoms. Vestibular rehabilitation therapy, a specialized form of physical therapy, can vertigo symptoms and other migraine symptoms.
While the exact cause of migrainous vertigo is not fully understood, a suspected vestibular migraine, along with other vestibular disorders, is believed to involve abnormal brain activity affecting the inner ear and balance system.
Vestibular Migraine Symptoms
The International Headache Society recognizes migrainous vertigo as a subtype of migraine. However, many patients, even migraine patients, do not have a headache as their dominant symptom for migraine-related vestibulopathy.
Vestibular migraine symptoms can vary widely but generally involve a combination of migraine and vestibular (balance-related) issues. Common symptoms include dizziness or a sensation of spinning (vertigo), which can last minutes to hours.
Vertigo:
Dizzy spells or feeling of dizziness.
Unsteadiness:
Difficulty maintaining balance during dizzy spells.
Nausea, Vomiting, and Dry Mouth:
Often accompanying dizziness or vertigo.
Motion Sickness:
Increased dizziness, motion sickness, and nausea with head movement or changes in position.
Throbbing Headache:
While throbbing headache attacks or other headache disorders are not typically the dominant symptom for all patients, a throbbing headache may occur alongside vestibular symptoms. The throbbing headache can occur with or without migraine aura.
Sensitivity to Light:
Discomfort or pain from bright or flashing lights.
Sound Sensitivity:
Increased sensitivity to loud noises.
Visual Disturbances:
Blurred vision or difficulty focusing.
Tinnitus:
Ringing or buzzing in the ears.
Fatigue:
General feelings of tiredness or weakness.
Difficulty Speaking and Concentrating:
Trouble focusing or mental fog.
These vestibular migraine symptoms can significantly impact daily activities and quality of life, making proper diagnosis, lifestyle changes, and vestibular migraine treatment essential.
Stages of Vestibular Migraine
Vestibular migraines typically follow a progression of stages, though the experience can vary from person to person. Understanding these stages can help manage migraine symptoms and treat vestibular migraines effectively.
This initial phase can start hours or even days before the actual vestibular migraine attack. Vestibular symptoms may include mood changes, cravings for certain foods, neck stiffness, frequent yawning, and increased sensitivity to light and sound.
Not all individuals experience a vestibular migraine aura. When a migraine aura occurs, it involves visual disturbances such as flashing lights, blind spots, or zigzag patterns with head movement. Other sensory disruptions, including tingling or numbness, and difficulty speaking or understanding language, can also be present. For vestibular migraines, migraine aura might include vertigo, dizziness, or nausea.
This is the main phase of migraine related vestibulopathy, where vertigo-associated dizziness is the dominant symptom. Vestibular migraine attacks may also involve severe nausea, vomiting, sensitivity to light and sound, and possibly a throbbing headache, though headache attacks are not always present. The duration of vestibular migraine attacks can range from a few minutes to several hours.
After the dominant symptom and other symptoms associated with headaches subside, individuals often feel drained and fatigued. Some may experience a mild, lingering headache, dizziness, or sensitivity to light and sound. Recovery can take a few hours to a couple of days.
By recognizing the stages of vestibular migraines, individuals can better anticipate and manage their symptoms with a suspected vestibular migraine, potentially mitigating the impact of vestibular migraines on their daily lives.
Vestibular Migraine Diagnostic Criteria
Diagnosing vestibular migraines involves specific diagnostic criteria to ensure an accurate identification of the condition. According to the International Classification of Headache Disorders (ICHD-3), a diagnosis of a suspected vestibular migraine requires at least five episodes of moderate to severe vestibular symptoms lasting between 5 minutes and 72 hours. Vestibular migraine episodes must be accompanied by a current or past history of migraine with or without migraine aura.
Additionally, at least half of the vestibular migraine episodes should include migraine-associated features such as headache, sensitivity to light or sound, or visual aura. Importantly, other potential causes of vertigo symptoms, such as neurological conditions or other vestibular disorders, such as ménière’s disease or benign paroxysmal positional vertigo, must be ruled out through thorough medical evaluation and testing.
This precise diagnostic approach helps distinguish vestibular migraines from other similar conditions, ensuring appropriate vestibular migraine treatment options.
When to See a Richardson Vestibular Migraine Headache Specialist
If you frequently experience episodes of vertigo, dizziness, or balance issues accompanied by migraine symptoms like headaches, sensitivity to light and sound, nausea, or visual disturbances, it may be time to see a Richardson vestibular migraine headache specialist.
These symptoms can significantly impact your daily life and may indicate a vestibular migraine. A chronic migraine specialist from the Eminent Headache and Migraine Center can provide a thorough evaluation, accurate diagnosis, and tailored treatment plan to manage your symptoms effectively.
Richardson Vestibular Migraine Treatment Options
Vestibular Migraine Non-Surgical Treatment Options
Dealing with migraine-associated vertigo or vestibular migraines can be challenging due to their disruptive symptoms, but for those in the DFW area, a variety of vestibular migraine treatment options are available to help manage and alleviate these symptoms.
Vestibular Migraine Medication
Medications for vestibular migraines are designed to address both the prevention of migraine episodes and the acute relief of vertigo symptoms and other associated discomforts. Preventative medications, such as beta-blockers, anticonvulsants, and calcium channel blockers, seek to reduce the frequency and intensity of vestibular migraine attacks.
During acute episodes, vestibular suppressants and anti-nausea medications can provide immediate relief from dizziness and nausea. In some cases, triptans and nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to alleviate headache symptoms.
By tailoring medication plans to individual needs and symptoms, healthcare providers can significantly improve the quality of life for those suffering from vestibular migraines.
Nurtec for Vestibular Migraine
Nurtec ODT (rimegepant) is an emerging treatment option for those suffering from vestibular migraines and other vestibular disorders. This oral medication is specifically designed to treat acute migraine attacks and is known for its quick onset of action and lasting relief.
By targeting the CGRP receptor, Nurtec can effectively alleviate symptoms such as vertigo, dizziness, and headache, often within an hour of administration. Additionally, its convenient orally disintegrating tablet form makes it easy to take without the need for water, offering a practical solution for individuals experiencing vestibular migraine symptoms on the go.
When taken regularly, Nurtec provides both acute relief and preventative benefits, making it a promising option for managing vestibular migraines.
Nortriptyline for Vestibular Migraine
Nortriptyline, a tricyclic antidepressant, is commonly prescribed for the prevention of vestibular migraines. This medication works by affecting the balance of certain chemicals in the brain, which can help reduce the frequency and intensity of migraine episodes. It’s particularly beneficial for individuals who experience chronic dizziness and vertigo symptoms associated with vestibular migraines.
Effexor for Vestibular Migraine
Effexor (venlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat vestibular migraines. This medication helps by regulating the levels of serotonin and norepinephrine in the brain, which can decrease the frequency and severity of migraine episodes and associated vertigo symptoms. Effexor is especially effective for those who experience chronic dizziness and imbalance due to vestibular migraines.
Botox for Vestibular Migraine
Botox (onabotulinumtoxinA) is a promising treatment option for chronic vestibular migraines. While traditionally known for its cosmetic uses, Botox has been approved for migraine prevention due to its ability to inhibit neurotransmitter release that leads to migraine pain.
During treatment, small amounts of Botox are injected into specific muscles around the head and neck, targeting areas associated with migraine onset. This can help reduce the frequency and severity of migraine episodes, including vertigo symptoms.
Botox treatments are typically administered every 12 weeks and can provide significant relief for those who have not responded well to other preventative medications.
Vestibular Migraine Physical Therapy (Vestibular Rehabilitation)
Vestibular rehabilitation therapy (VRT) is a highly effective vestibular migraine treatment. This specialized form of physical therapy alleviates dizziness, vertigo, and balance issues by retraining the brain to process vestibular signals more effectively.
Through customized exercises, VRT helps improve gaze stability, enhance postural control, and reduce sensitivity to motion. Patients typically engage in activities that promote coordination, balance, and strength, which can significantly diminish the impact of vestibular symptoms on daily life.
Under the guidance of a skilled healthcare provider, migraine patients learn techniques to manage and mitigate their symptoms, leading to a substantial improvement in their overall quality of life. By addressing both the physical and neurological aspects of vestibular migraines, VRT offers a comprehensive approach to managing vestibular migraine symptoms.
Surgery for Vestibular Disorders
Surgery for vestibular migraine treatment is considered when other treatments, such as medications, physical therapy, and lifestyle changes have not provided sufficient relief. The surgical options for migraine-related vestibulopathy address the underlying causes of persistent vertigo and balance issues.
Surgical procedures include vestibular nerve section, labyrinthectomy, and endolymphatic sac decompression. These surgeries can offer significant relief for patients with debilitating vestibular migraines, restoring their ability to engage in daily activities without constant disruptions from vertigo and balance problems.
Labyrinthectomy
A labyrinthectomy is a surgical procedure to alleviate severe and chronic vertigo associated with migraine related vestibulopathy and other vestibular disorders, such as Ménière’s disease. This operation involves removing or disabling the labyrinth, the part of the inner ear responsible for balance, thereby preventing the abnormal signals that cause vertigo.
It is usually recommended for patients who have experienced significant hearing loss in the affected ear since the procedure results in complete and irreversible hearing loss.
Despite this significant trade-off, the relief from debilitating vertigo can be profound, allowing patients to regain stability and engage in daily activities without the constant threat of vertigo episodes. Labyrinthectomy treatment is often a last resort option to treat vestibular migraine patients but can be life-changing for those suffering from debilitating vestibular symptoms when other treatment options have failed.
Chemical Labyrinthectomy
A chemical labyrinthectomy is a minimally invasive procedure used for severe vestibular migraine treatment, especially in cases of Ménière’s disease. This approach involves injecting a medication, typically gentamicin, into the middle ear. Gentamicin selectively damages the balance-sensing cells, which helps to reduce or eliminate the abnormal signals responsible for migrainous vertigo.
The procedure used to treat vestibular migraines is usually performed on an outpatient basis and is considered less invasive than a surgical labyrinthectomy. However, like other treatments, it carries a risk of hearing loss in the treated ear, making this vestibular migraine treatment a suitable option for patients with significant hearing impairment or those who have not responded to other treatments.
Vestibular Nerve Section
A vestibular nerve section is a surgical procedure that can relieve severe migrainous vertigo in patients with vestibular disorders, such as Meniere’s disease, who have not responded to other treatments.
Vestibular nerve section involves cutting the vestibular nerve, which transmits balance information from the inner ear to the brain. Severing this nerve stops the abnormal signals that cause vertigo, significantly reducing or eliminating vestibular migraine episodes. This vestibular migraine treatment is performed under general anesthesia and typically requires a hospital stay.
While this migrainous vertigo treatment preserves hearing in most cases, any surgical intervention has risks, including potential complications and the need for recovery time. Despite these considerations, a vestibular nerve section can offer substantial relief for those with debilitating vertigo.
Endolymphatic Sac Decompression
Endolymphatic sac decompression is a surgical procedure that can potentially alleviate the symptoms of Meniere’s disease and other vestibular disorders. This vestibular migraine treatment involves creating an opening in the endolymphatic sac to relieve excess fluid pressure that is thought to contribute to the symptoms.
By reducing this pressure, the procedure can help stabilize the fluid levels within the inner ear, thereby decreasing the frequency and intensity of migraine associated vertigo episodes and potentially preserving hearing. The surgery is typically performed under general anesthesia and can be done on an outpatient basis or with a short hospital stay.
While less invasive than other surgical options like labyrinthectomy, endolymphatic sac decompression carries risks and potential complications. Nonetheless, it offers a promising solution for patients with Meniere’s disease who have not found sufficient relief from medication or lifestyle changes.
Oval or Round Window Plugging
Oval or round window plugging is a surgical procedure to treat certain vestibular disorders, such as superior semicircular canal dehiscence (SSCD) and perilymph fistula. These conditions can cause debilitating vertigo, balance issues, and hearing problems due to abnormal openings in the inner ear.
The surgical procedure involves sealing the oval or round windows, which are membranous openings in the bony labyrinth of the inner ear, to prevent abnormal fluid movement and pressure changes that trigger vertigo and other symptoms.
This surgery, performed under general anesthesia, stabilizes the inner ear environment, thereby reducing or eliminating vertigo episodes and improving hearing stability.
While the procedure carries typical surgical risks, it is generally well-tolerated and can provide significant symptom relief for patients who have not responded to conservative treatments for vestibular migraines.
Pneumatic Equalization (PE) Tubes
Pneumatic Equalization (PE) tubes, or ear tubes, are sometimes used to treat vestibular disorders and migraines associated with middle ear dysfunction. These small, hollow cylinders are surgically inserted into the eardrum to help manage chronic fluid buildup and pressure imbalances that can contribute to vertigo and other vestibular disorders.
The procedure, performed under local or general anesthesia, creates an airway that allows for proper middle ear ventilation, equalizing pressure and preventing the accumulation of fluids. This can benefit individuals experiencing recurrent episodes of vertigo or vestibular migraines linked to middle ear issues, as it helps stabilize the ear’s internal environment, reducing the frequency and severity of symptoms.
PE tubes typically stay in place for several months to a year and often fall out naturally as the eardrum heals. By improving ear drainage and pressure regulation, PE tubes can offer significant relief and enhance the quality of life for patients with vestibular disorders and migraines.
Canal Partitioning (Canal Plugging)
Canal partitioning, also known as canal plugging, is a surgical treatment for certain vestibular disorders, such as superior semicircular canal dehiscence (SSCD) and benign paroxysmal positional vertigo (BPPV).
This procedure involves carefully inserting a plug to block the affected semicircular canal in the inner ear, preventing abnormal fluid movement that causes vertigo and balance issues. Performed under general anesthesia, canal plugging is designed to stabilize the inner ear’s environment, thereby reducing or eliminating vertigo episodes and improving overall balance. The surgery is typically well-tolerated, with most patients experiencing significant symptom relief and an enhanced quality of life.
Richardson Vestibular Migraine Specialist
Choosing the right migraine specialist in Dallas and Richardson, TX, is crucial for effectively managing vestibular migraines, and the experts at Eminent Medical Center in Richardson are dedicated to providing comprehensive care tailored to each patient’s unique needs.
With a deep understanding of vestibular disorders and a commitment to cutting-edge treatments, our specialists work collaboratively to develop personalized plans that address the root causes of your vestibular migraine symptoms.
Whether through medication, physical therapy, or advanced surgical options, our goal is to help you regain control of your life and alleviate the debilitating effects of vestibular migraines.
Call (469) 910-8800 to schedule an appointment with a Richardson vestibular migraine specialist today.