Can Migraines Make You Dizzy? 5 Strong Reasons Why

Migraines (technically called migraine attacks) are highly disabling neurological events. With over 40 million Americans impacted, migraine disorder is by all means an epidemic. More than a headache, migraine is a complex neurological disorder.

People may be familiar with symptoms such as headache and light and sound sensitivities but migraine goes much deeper than that. It can actually present with all kinds of weird symptoms like facial pain, visual disturbances, or even difficulty with speech. One of the most common complaints we hear with migraine though is dizziness.

According to the Vestibular Disorders Association (VEDA), about 30-50% of migraine patients report dizziness and vertigo during an attack. But before diving into why that is, we first need to define what dizziness and vertigo actually are.

Can Migraines Make You Dizzy? Defining Dizziness & Vertigo

The term dizziness is more complex than people realize. While we’ve all experienced dizziness at one point, the experience of dizziness can actually take on many different qualities. Dizziness is often described as a sense of:

• Lightheadedness: feeling like you might faint
• Disequilibrium: feeling off-balanced
• Wooziness: feeling disoriented
• Unsteadiness: a loss of balance
• Vertigo: a false sense of movement

The term vertigo also often gets equated to a sense of room spinning dizziness. While vertigo can cause a room-spinning sensation, it is actually more accurately defined as an illusory sense of movement when in fact there is none. Therefore, vertigo can also present as a sense of bobbing, swaying, rocking, or even internal movement. These concepts are important to understanding dizziness in migraine.

5 Reasons Migraine Attacks Can Make You Dizzy

1. Vestibular Migraine

Migraine is a complex neurological disorder that can impact the entire body, not just a headache. A migraine attack can disrupt the autonomic nervous system, that is the automatic physiological processes we don’t have control over. Think things like heart rate, blood pressure, or sweating. In fact, it is now well established that our autonomic system will present with signs that a migraine attack is coming such as yawning or increased urinary urgency beforehand.

When the autonomic nervous system isn’t regulating properly, people can experience light-headedness. Instead of a room spinning sensation, people often describe this form of dizziness as feeling like they could pass out.

3. Sensory Mismatch (Visual-Vestibular-Neck Conflict)

Besides vertigo, people with migraine also often report neck pain and visual disturbances. Your brain constantly integrates information from your eyes, inner ear, and neck to maintain an upright head position. So when we see disruptions in visual and neck functions, the brain receives conflicting information from all three systems, producing a sense of dizziness.

The dizziness that comes with sensory mismatch typically is not described as a room spinning. Rather, it is a vague feeling of “feeling off” or disoriented.

4. Postdrome (“The Migraine Hangover”)

Migraine attacks occur in phases including both periods before and after the main attack, labelled as prodrome and postdrome respectively. The postdrome phase is often described as a “migraine hangover”, where the brain has to readjust and recover.

Lingering dizziness, fatigue, and brain fog are all common during postdrome. It can last for hours or even a few days and is a common but under recognized part of the migraine cycle.

5. Increased Risk of Other Vestibular Conditions

• Meniere’s Disease
• Benign Paroxysmal Positional Vertigo
• Vestibular Neuritis
• Vestibular Labyrinthitis

These disorders often come with other unique features, such as changes in hearing, increased sensitivity to head movement, or visual issues. Vestibular migraine is tricky in that it can mimic any of these disorders. A skilled clinician is able to differentiate these disorders and even detect coexistence.

For a more complete list of vestibular disorders, you can check out our service page dedicated to vestibular therapy.

So What’s the Solution?

Dizziness in migraine is a complex subject and can present in a variety of ways. Treatment is going to look very different person to person but the best results come from interdisciplinary care.

Considering medication is important for migraine, more so than most other vestibular disorders. Ideally, your physician should be a neuro-otologist or certified headache specialist to help you navigate medications.

Vestibular rehabilitation, a specialized form of physical therapy for dizziness and vertigo, is also indicated. The aim is to recalibrate any disruptions in visual, cervical, or inner ear sensory processing for better function. The benefits of vestibular rehabilitation in migraine management are well documented but public awareness remains low.

Finally, it is critical to address lifestyle factors when it comes to managing migraine. This is perhaps the most foundational piece to effective migraine treatment. High-quality sleep, stress management, and eating regular meals all go a long way in keeping migraine attacks at bay.

If you’re having difficulty getting a handle on your migraine attacks, you’re not alone.

Dizziness often requires a more individualized approach. A personalized plan can help clarify what’s contributing to your symptoms and outline next steps. Get your FREE treatment plan from Pang PT here.