How I Overcame My Vestibular Migraine: My Personal Journey and Practical Guide

Vestibular migraine changed my life: spinning dizziness, nausea, balance loss and headaches would come out of nowhere. After years of searching, I finally found a combination of lifestyle changes, targeted therapies and medications that worked. Here’s exactly what helped me—and how you can apply these strategies too.

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Understanding Vestibular Migraine

Vestibular migraine is a recognized subtype of migraine that features both migraine headaches and vestibular (balance) symptoms. According to Lempert et al. (2012) and Bisdorff et al. (2013):

• Recurrent vestibular symptoms (vertigo, unsteadiness) lasting minutes to hours
• History of migraine with or without aura
• At least five episodes with one migraine feature (headache, photophobia, phonophobia)
• No better explanation by another disorder

Common clinical characteristics:

• Women are affected more often than men.
• Family history of migraine is common.
• Motion sensitivity and specific triggers often play a role.

Understanding these criteria helped me confirm my diagnosis, rule out other causes (like inner-ear infection), and target the right treatments.

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Identifying Your Personal Triggers

Each person’s triggers can differ, but these are the most common for vestibular migraine:

• Stress and anxiety
• Sleep disturbances or jet lag
• Hormonal fluctuations (women)
• Certain foods and beverages (aged cheese, processed meats, red wine, caffeine)
• Sensory overload (bright lights, loud sounds, strong smells)
• Dehydration or irregular meals

I kept a daily journal for three months, noting food, sleep hours, stress levels and any migraine or dizzy spells. Patterns emerged:

• Skipping breakfast almost always led to afternoon dizziness.
• Red wine or strong coffee before bed triggered night-time vertigo.
• Late nights and screen fatigue increased head-spin episodes.

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Lifestyle and Diet Modifications

1. Regular Sleep-Wake Schedule

   • Go to bed and wake up at the same times—even on weekends.
   • Aim for 7–8 hours nightly.

2. Balanced, Timed Meals

   • Eat every 3–4 hours; don’t skip breakfast.
   • Include protein, healthy fats and low-glycemic carbs to stabilize blood sugar.

3. Hydration

   • Drink at least 2 liters of water daily.
   • Reduce or eliminate alcohol, especially red wine.
   • Limit caffeine; switch to green tea if needed.

4. Magnesium and Riboflavin

   • I took 400 mg magnesium citrate daily (helps nerve function).
   • Added 400 mg riboflavin (vitamin B2) each morning—shown to reduce migraine frequency.

5. Stress Management

   • Daily meditation or deep-breathing for 10 minutes.
   • Short walks or gentle yoga to clear the mind.

These changes didn’t cure me overnight, but within four weeks I saw a 30% drop in dizzy spells.

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Vestibular Rehabilitation and Exercise

Because vestibular migraine affects balance, I worked with a physical therapist on vestibular rehabilitation (VR). Key exercises included:

• Habituation Exercises

• Gradual exposure to head movements that provoke mild dizziness (e.g., turning head side to side).

• Gaze Stabilization

• Focus on a fixed target while moving the head to train visual-vestibular interaction.

• Balance Training

• Standing on foam pads, walking heel-to-toe, closing eyes during stance.

At least 20 minutes of VR exercises, three times per week, sped up my brain’s ability to adapt. Over two months, my baseline dizziness decreased significantly.

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Medication Strategies

After lifestyle and VR alone plateaued, I added medications under my doctor’s guidance:

1. Preventive Medications

   • Propranolol (beta-blocker): 40 mg twice daily
   • Topiramate: Started 25 mg at night, titrated to 75 mg
   • Amitriptyline: 10–25 mg at bedtime (helped with sleep and migraine prevention)

2. Abortive (Rescue) Medications

   • Triptans (e.g., rizatriptan): At first sign of headache or vertigo
   • Anti-nausea (ondansetron or metoclopramide) if vomiting or severe nausea occurred
   • Nonsteroidal anti-inflammatories (ibuprofen) for mild headache relief

Working closely with my neurologist, we found the right doses and combinations. Preventive meds took 6–8 weeks to show full benefit; abortives stopped attacks mid-course.

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Alternative and Complementary Therapies

I also explored gentle, nonpharmacological options:

• Acupuncture: Weekly sessions for 6 weeks helped reduce headache intensity.
• Biofeedback: Learning to control muscle tension and heart rate reduced stress-induced attacks.
• Mindfulness-Based Stress Reduction (MBSR): An 8-week program that lowered overall migraine frequency.

These therapies added small but meaningful improvements when combined with my core plan.

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Putting It All Together: My Daily Routine

Morning

• Wake at 7 AM, 400 mg riboflavin, breakfast with eggs/avocado
• 10 minutes guided meditation

Midday

• Light lunch + magnesium supplement
• 10-minute vestibular exercises or short walk

Afternoon

• Hydrating herbal tea, balanced snack if needed
• Screen break every hour

Evening

• Light dinner, avoid red wine/caffeine
• Vestibular rehab (20 minutes), gentle stretching/yoga
• Medications (propranolol or topiramate)
• Wind-down routine: low lights, no screens 1 hour before bed

This structured approach, maintained consistently for three months, cut my vestibular migraine attacks by over 80%.

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The Road to Recovery

My progress wasn’t linear. I had setbacks—illness, travel, missed meds—but I learned to:

• Re-evaluate triggers after each flare.
• Adjust preventive doses or switch medications if side effects arose.
• Return quickly to my routine after disruptions.

Today, I experience rare, mild episodes that respond to abortive meds and a quick vestibular exercise session. My life feels normal again.

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Next Steps: Check Your Symptoms

If you suspect vestibular migraine or are unsure about your symptoms, consider a free, online symptom check for vestibular migraine to help you decide when to seek medical advice.

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Important: This guide reflects my personal experience and references established criteria (Lempert et al. 2012; Bisdorff et al. 2013). Always speak to a qualified healthcare professional before starting or changing treatment—especially for anything life-threatening or serious. If you experience severe, sudden symptoms (e.g., stroke-like signs, chest pain, confusion), call emergency services immediately.