Sky Lakes Medical Center | Live Smart | Late Spring 2021 | LIVE smart 7 By Alek Angeli, PT, DPT, Sky Lakes Outpatient Rehabilitation The vestibular system of the inner ear and brain controls balance and how people understand the space they’re in. When this is affected, someone may experience feelings of vertigo, unsteadiness or dizziness, which can be triggered by movement. People with vestibular migraine typically have attacks of spinning, tilting, rocking, swaying and imbalance. These are usually spontaneous. Between attacks, it is very typical for patients to have hypersensitivity to motion, sound, light, smells and medications. With a keen eye, physicians will notice that vestibular migraine patients have increased head motion sensitivity, visual motion sensitivity and exaggerated sway with standing. Prevention and management Prevention includes lifestyle changes and physical therapy. Lifestyle changes—related to exercise, eating (identify triggering foods), hydration (avoid caffeine/ alcohol) and stress management (mindfulness, talk therapy, exercise)—can help you deal with vestibular migraines. Vestibular physical therapy can help desensitize the brain to head and body motion or visual motion to help reduce triggering of attacks. Management focuses on reducing the duration and severity of an attack when it occurs. Medications typically used include anti-nausea, anti-inflammatory, anti-migraine, and antihistamines that have dual purpose as vestibular suppressants. These medications are not intended to be used long-term and can have long-term side effects. They are safe if used a few times a month. Once a migraine attack is controlled, a vestibular physical therapist helps identify activities that provoke dizziness, nausea or unsteadiness and works to reduce patient sensitivity. Exercises include head movements, standing and walking balance activities, and graded exposure to aggravating activities. Ultimately, the exercises help patients to be able to tolerate normal amounts of light, sound and activity around them. Diagnosing vestibular migraine Many patients who have vestibular migraine have at least five moderate to severe attacks of vertigo (any hallucination of movement, not just spinning), lasting five minutes to 72 hours at a time. With these attacks, Alek Angeli, PT, DPT , is a doctor of physical therapy at the Sky Lakes Outpatient Rehabilitation/Medical Center Campus and specializes in vestibular therapy. Call 541-837-1989 to learn how vestibular therapy can help you get your life back in balance. Feelings of dizziness or vertigo may mean vestibular migraine READY, STEADY, QUIZ Do you know when dizziness is an emergency? Test yourself at . headache, sensitivity to light and sound, or visual aura must be present half of the time. Vestibular migraine is a fairly common occurrence—up to 3% of the population has it—and headaches do not need to be a prominent feature in order to be diagnosed with vestibular migraine. It is likely an inherited disorder that can become active with factors such as stress; hormone fluctuations; and irregular sleep, eating, exercise or drinking schedules. Lifestyle changes are paramount, medications can be helpful and physical therapy can be useful as treatment for many people.