Vestibular migraine is a nervous system disorder in which the main symptom is dizziness with a history of migraine. The episode of vertigo may last from 5 minutes to 72 hours, and this occurs independently of the headache. Headache is not a classic symptom. Some people do not experience a headache at all. The other associated symptoms are feeling of nausea and vomiting, feeling imbalanced, motion sickness, increased sensitivity to motion, sound, and light. A Vestibular migraine occurs in 10% of migraine patients. It is more common in women. Vestibular migraines can also occur in children.
Triggers of Vestibular Migraine-
- Certain medications.
- Environmental triggers, like bright light and temperature changes.
- Hormone fluctuations with menstruation.
- Too much stress.
- Sleep deprivation.
- Certain foods like aged cheese, chocolates, dairy products, artificial sweeteners, caffeine, and alcohol.
The mainstay of treatment for Vestibular Migraine is medication. Besides this, lifestyle modifications, like maintaining diet, consistent sleep patterns, adequate fluid intake, reducing stress, exercising regularly, and avoidance of triggers are recommended as they are for migraines.
Vestibular Rehabilitation Therapy (VRT) is very effective in reducing symptoms of vestibular migraine and to restore function. VRT includes combined specific head and body movements with eye exercises. If these exercises are performed correctly, muscle tension, headaches, and fatigue will diminish, and symptoms of dizziness, vertigo, and nausea will decrease. Most VRT exercises involve head movement. Head movements are essential in stimulating and retraining the vestibular system.
Gaze stabilization Exercises
Gaze stabilization is the ability to hold the visual world steady while the head and body are moving. The vestibulo-ocular reflex (VOR) helps to provide gaze stability when the head moves.
Fix your gaze at one point in front of you at eye level, then move your head from side to side (45 degrees to each side) while keeping the gaze fixed. Similarly, it can be done by moving the head vertically up and down, while keeping the gaze fixed at the target.
Static balance activities used for training include Standing straight with feet close together and standing on one leg. Exercises are made more challenging by altering the surface on which the person stands, like foam, trampoline, tilt board. Maintaining static positions with eyes closed and lastly incorporating head motions while maintaining balance.
Dynamic balance is taught by performing activities including walking with head turns, full-body turns, and marching in place. Dynamic activities are made more challenging by altering the surface (like a balance beam, treadmill), and performance with eyes open and eyes closed.
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