Vestibular Migraine

Vestibular migraine is one of the most common causes of recurrent vertigo and dizziness. It is a form of migraine in which dizziness and balance symptoms are a prominent feature — with or without a headache. Management combines medical care (often with a GP or neurologist) and vestibular rehabilitation to reduce symptoms and improve function.

Understanding Vestibular Migraine

Migraine affects how the brain processes sensory information, including balance and movement. In vestibular migraine, this leads to episodes of dizziness and vertigo that may occur alongside, before, after, or completely independent of a headache.

Signs and Symptoms

Episodes can last minutes to days and may include:

• Vertigo (spinning) or a swaying/rocking sensation
• Dizziness and unsteadiness
• Sensitivity to motion and head movement
• Sensitivity to light, sound, or busy visual environments
• Nausea
• Headache (not always present)
• Brain fog and fatigue

Common Triggers

• Stress and poor sleep
• Certain foods, caffeine, or dehydration
• Hormonal changes
• Bright lights and busy visual environments
• Weather or barometric changes

Assessment

Our vestibular physiotherapists work to:

• Identify the migraine pattern and distinguish it from other vestibular disorders
• Screen for BPPV and other causes that can coexist
• Assess balance, gaze stability, and motion sensitivity
• Map your triggers to guide a management plan

We often coordinate with your GP or neurologist, as medication and lifestyle management play an important role.

Physiotherapy Treatment

Vestibular Rehabilitation

• Gaze stability and balance exercises
• Habituation for motion sensitivity
• Graded return to activities and busy environments
• Individualised, paced progression to avoid flare-ups

Trigger and Lifestyle Management

• Identifying and reducing personal triggers
• Sleep, hydration, and routine strategies
• Education on managing and pacing through episodes

Collaborative Care

• Working alongside medical management
• Supporting return to work, study, and daily life

A Combined Approach Works Best

Vestibular migraine usually responds best to a combination of medical management (lifestyle, triggers, and sometimes medication) and vestibular rehabilitation to address dizziness, balance, and motion sensitivity.

Expected Outcomes

With a combined approach, most people achieve fewer and less severe episodes, improved balance and confidence, and a better ability to manage symptoms day to day.