A sudden dizzy spell or a light-headed turn is, for many, an occasional annoyance. But for millions of adults, chronic dizziness can become an almost disabling condition.
While most cases are attributed to inner-ear problems, low blood pressure or certain medications.
But experts speaking to the Daily Mail warn that a significant number of sufferers could in fact have a little-known ‘hidden’ neurological disorder.
Dubbed ‘the most common disease you’ve never heard of,’ vestibular migraine occurs when nerve cells in the brain misfire – much like in a typical migraine.
However, unlike other forms of migraine, it does not usually cause a throbbing headache. Instead, sufferers experience extreme bouts of vertigo, dizziness and imbalance – often alongside nausea, sensitivity to light and sound, and motion sickness – that can last anywhere from five minutes to an hour.
Because there’s no head pain, experts say many doctors mistakenly rule out migraine, instead attributing the problem to other vertigo-inducing conditions such as benign paroxysmal positional vertigo, which occurs when microscopic crystals in the inner ear become dislodged.
In fact, a 2018 study found that just one in ten people with vestibular migraine had received the correct diagnosis.
But without a proper diagnosis, experts warn, patients can be left to suffer life-ruining symptoms without the treatment that could help them.
For finance worker Craig Hogan, his first dizzy spell struck just before the pandemic, as he found himself collapsing to the floor trying to get up from his sofa
‘A huge number of people will have vestibular migraine and not know it,’ says Dr Diego Kaski, consultant neurologist and honorary associate professor at University College London. ‘This is largely because of a lack of recognition of what it is – among patients and doctors. But it’s a huge pity, as many may be dealing with what they assume are just dizzy spells for years without knowing there are simple ways to reduce them.’
There are no specific blood tests or brain scans for vestibular migraine. Instead, a diagnosis is usually made after other conditions have been ruled out.
But there are some risk factors to look for.
‘Patients with a history of headaches should ring alarm bells for primary care doctors if they’ve come in complaining of dizzy spells,’ says Dr Kaski. ‘Women are also more likely to get vestibular migraine than men.’
One of the strongest predictors of a predisposition to vestibular migraine is getting sick while reading in a car.
‘If you have motion sickness when reading in the passenger seat, you’re 17 times more likely to develop the condition than those who don’t,’ adds Dr Kaski.
For finance worker Craig Hogan, his first dizzy spell struck just before the pandemic, as he found himself collapsing to the floor trying to get up from his sofa.
‘I hadn’t been drinking and wasn’t even particularly tired, but as I stood up it felt like my head was doing a roly-poly,’ says the 47-year-old from Preston, Lancashire, in England. ‘The next thing I knew, I was on my hands and knees.’
Dubbed ‘the most common disease you’ve never heard of’, vestibular migraine occurs when nerve cells in the brain misfire – much like in a typical migraine
Luckily for Craig, his wife Leanne was close by to help him upstairs and into bed. But it took a couple of days off work to recover – during which he was unable to get up or look at a screen.
After seeing his doctor, Craig was diagnosed with labyrinthitis, an inflammation of the inner ear that causes sudden vertigo, dizziness and nausea, and which tends to go away after a couple of days.
But over the next few years, Craig’s dizzy spells occurred with increasing frequency – taking a massive toll on his life. He says: ‘At one point I was getting them daily. I couldn’t work or leave the house. It was debilitating.’
Craig eventually received a diagnosis of vestibular migraine. Today he says he can’t remember the last time he had a dizzy spell.
His secret? A series of diet, exercise and lifestyle changes.
Research has shown that a diet low in processed foods and artificial sweeteners can reduce the frequency of vestibular migraine attacks. Regular exercise also appears helpful – reducing inflammation in the brain and training the nervous system to become less reactive to everyday movements.
And one of the best-evidenced ways to reduce migraines of any sort is even simpler: routine.
‘The migraine brain loves regularity – whether that’s going to bed or waking up at the same time every day, not missing meals or eating on a strict schedule,’ says Dr Kaski. ‘Getting enough sleep is also really important, as this can lessen pressure on the brain.’
Newer medications, called calcitonin gene-related peptide inhibitors, have shown promise in early trials for vestibular migraine.
For Craig, identifying and understanding what was causing his dizzy spells proved more helpful than any medication. He says: ‘I used to be a nervous wreck. Now I look after myself much more – and it has transformed my life.’