Questions from our readers

I have dizziness and it doesn’t go away, it subsides for a little but is still there each day.   My doctor diagnosed me as having vestibular migraine, but I don’t get migraines, just bouts of vertigo and dizziness.  Will vestibular therapy help?

You were smart  to see your doctor. The first step when you develop daily dizziness that does not go away with simple maneuvers is to see your physician and have testing of your balance system.  This can show whether there is any damage to an inner ear or the brain balance system, which will help narrow down the cause.  If your testing was normal, migraine will often be diagnosed as the cause of the dizziness.  It is important to know that migraine is a common cause of dizziness, but migraine can be caused by different diseases and is associated with a variety of inner ear disorders. 

For example, sleep apnea is a common cause of migraine flare-ups and dizziness.  Daily dizziness is also very common with sleep apnea.  Loud snoring is a common symptom of this condition.   This problem can cause you to stop breathing for a minute or so, repeatedly during the night.   The low oxygen that results causes your arteries to go into spasm even when you’re awake, which can cause migraine headaches or auras—seeing flashing lights or zigzags in vision.  It can also cause dizzy spells that can be momentary– a flash of dizziness–or can cause more severe symptoms like a spinning feeling that goes on for hours.  Ask your doctor to screen you for this common cause of migraine and dizziness.

Migraine sufferers have BPPV more often than other people.  The symptom is brief spinning brought on by moving the head up or down or by rolling over or arising from bed.  This is usually  relieved with home exercises. 

Migraine can rarely damage the ear permanently.  This would show up on a test of inner ear function (VNG).  The treatment for permanent damage is to go through a program of vestibular rehabilitation.   Our video on inner ear damage home exercises may also help with the symptom.

In our next post, we’ll take explore a very rare cause of dizziness.