Headaches aren’t the only symptom of migraine. Many people with migraine also feel different kinds of dizziness during an attack, such as lightheadedness, feeling off balance, or a floaty sensation. Some people may also experience vertigo, a more specific type of dizziness. “I’ve been struggling with migraine symptoms on and off for the past week, and now I have vertigo added to it,” one MyMigraineTeam member said.

Vertigo is a type of dizziness that feels like movement when there is none. People with vertigo may feel as if the room is spinning, tilting, or swaying, like being on a boat. This is different from other forms of dizziness, which may feel more like lightheadedness or unsteadiness.

If you’ve ever had any of these sensations while living with migraine, this article is for you. Read on to discover how migraine and dizziness may be connected, along with tips that may help you feel steadier.

Vertigo as a Migraine Symptom and Trigger

Migraine is a neurological condition. It affects how the brain processes sensory information (signals like light, sound, and balance). During attacks, some people have vision problems, nausea, sensitivity to light and sound, and changes in balance and spatial awareness (knowing where your body is in space).

Some people also experience dizziness, including imbalance or spinning sensations, as part of a migraine attack.

Vertigo and migraine may involve some of the same sensitive (or “irritable”) brain pathways. Because of this, vertigo can sometimes happen before or during a migraine attack, and in some people, it may even seem to trigger one.

The parts of the brain that control balance and pain are closely connected. When one becomes overstimulated, it may also affect the other, leading to a cycle of symptoms.

Some research suggests a possible link between vertigo and migraine attacks, but more studies are needed to fully understand this connection. In one older study, researchers intentionally triggered vertigo (brought it on in a controlled setting) to see whether it would affect migraine symptoms. About half of the participants living with migraine experienced an attack within 24 hours of the vertigo episode.

Types of Vertigo

Vertigo can cause symptoms similar to those of a migraine attack, including:

• Dizziness
• Balance issues
• Hearing problems
• Nausea and vomiting

There are two basic types of vertigo: peripheral and central.

Peripheral Vertigo

Peripheral vertigo is related to problems with the inner ear and vestibular nerve (the nerve that helps control balance). These parts of the body help you sense movement and stay steady.

Peripheral vertigo is more common than central vertigo. It can be caused by several conditions, including:

• Benign paroxysmal positional vertigo (BPPV)
• Infections, including labyrinthitis and neuritis
• Ménière’s disease

Tiny crystals in the inner ear help determine your sense of balance. In BPPV, these crystals shift from their normal position. They travel from one part of the inner ear to another, causing vertigo. Specific head movements can help guide the crystals back to their original position. Your healthcare provider can show you how to do these movements at home.

Ménière’s disease is a rare disorder of the inner ear. Health experts aren’t exactly sure what causes it. But too much fluid in the inner ear leads to the vertigo symptoms associated with the disease. Migraine headaches may contribute to this fluid buildup in some cases.

Allergies and infections may also be to blame. Ménière’s disease and migraine can both run in families and cause major balance problems, though they require different treatments.

Central Vertigo

Central vertigo is caused by a condition affecting the brain. It’s less common but can be more serious. It can make it hard to walk or stay balanced. People with traumatic brain injuries, strokes, or brain infections may have central vertigo.

Members of MyMigraineTeam have talked about debilitating vertigo symptoms. “I had vertigo on the ride to work. I almost lost my balance walking into the office,” said one member.

It’s important to understand that different types of vertigo can feel similar but have different causes. Although peripheral (ear-related) vertigo can feel more intense and cause more nausea, central (brain-related) vertigo may need more urgent medical attention because it affects the brain.

If you notice new, severe, or unusual symptoms, it’s important to talk with your healthcare provider.

Vestibular Migraine

A specific type of migraine, called vestibular migraine, can cause vertigo as a primary symptom. During a vestibular migraine attack, you may feel like you’re falling or the world around you is moving.

Vestibular migraine episodes can happen without warning. Certain triggers, like looking at moving objects or putting your head in a certain position, may also bring on symptoms in some people.

How Common Is Vestibular Migraine?

Vestibular migraine is the second most common cause of vertigo, affecting 3 percent of adults. It’s five times more common in women than in men, according to the American Migraine Foundation. Many people with vestibular migraine had motion sickness as children.

Vestibular Migraine Symptoms

Headaches can be part of a vestibular migraine attack, but not always. Other possible symptoms of vestibular migraine include:

• Blurry vision
• Brain fog or trouble finding words
• Diarrhea
• Dry mouth
• Sensitivity to lights and sounds
• Sweating
• Tender scalp
• Tingling sensations
• Yawning

Finding Your Triggers

Vertigo that consistently happens right before, during, or after a migraine attack may be a sign of vestibular migraine. Pay attention to the timing, patterns, and triggers of your migraine attacks. These details can help clarify what’s happening in your body and brain. Like other types of migraine, vestibular migraine triggers are unique for each person.

Other triggers may include changes in:

• The weather
• Hormones (like during a menstrual cycle)
• Eating habits
• Stress levels
• Sleep schedule

Some people’s migraine attacks have specific triggers, like chocolate, caffeine, alcohol, or flashing lights. Keeping a headache journal (where you write down your symptoms and the factors leading up to them) can help pinpoint your triggers.

Managing Vertigo and Migraine Attacks

Vertigo and migraine can share similar triggers, including flashing lights or stress. Dizziness can also be a symptom of migraine, especially in cases of vestibular migraine.

To get answers, you’ll need to see a headache specialist or a neurotologist (a doctor who specializes in balance and inner ear disorders). Remember to bring your symptom journal to your appointment.

Your healthcare provider may recommend medication, supplements, lifestyle changes, or other treatment options to get your condition under control. Preventive medications are taken daily to help avoid migraine attacks.

Other medications are used during an attack to reduce the immediate symptoms. Neuromodulation devices that stimulate specific nerves can also help.

Consistent daily routines are important for people with a history of migraine attacks. Regular mealtimes, good sleep habits, and stress management should be a top priority.

Some people, especially those with BPPV, find that sleeping with their head raised on two pillows may help with vertigo by keeping the ear crystals in place. This typically doesn’t help with vestibular migraine and may end up causing neck strain, which may trigger more migraine attacks.

Vestibular rehabilitation therapy includes a range of exercises you can do for vertigo. Your healthcare provider can teach you the techniques. As part of therapy, they may recommend:

• Stretching
• Marching in place
• Strengthening exercises
• Eye movement control exercises

Allergy medicine or motion sickness medications can offer immediate relief from vertigo symptoms, depending on your situation.

If you’re having a migraine attack, give yourself permission to rest. You may need to take some time out in a quiet and dark room. Cold or warm compresses and massages can help you feel better.

When To Seek Urgent Medical Care

Sometimes migraine or vertigo symptoms are severe enough to warrant a trip to the emergency room. Get immediate medical attention if you have:

• A headache that’s more intense than you’ve ever had
• A seizure
• Changes in vision or your ability to speak
• Chest pain
• Heart palpitations
• Loss of balance and stability
• A fever over 100.4 degrees Fahrenheit
• Weakness in one leg or arm

If your symptoms are happening after a recent head injury, don’t delay getting follow-up care. Call your provider or dial 911 to report your symptoms. You shouldn’t drive if you’re feeling dizzy. Have an ambulance or a loved one take you to get the care you need.

Join the Conversation

On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.

Do you have migraine-associated vertigo? Let others know in the comments below.