Central vertigo associated with migraine

Low urgency
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Spinning sensation that appears in the context of a strong headache.

The exact cause is unknown, although several triggering factors have been described: stress, some foods, changes of sleeping hours, hormonal changes and smoking.

Nausea, vomits, loss of balance and hearing disturbances may appear alongside the headache with a spinning sensation.

The diagnosis is clinical, through questioning and physical examination with a full neurological examination. Additional tests may be requested to complete the picture: blood tests, auditive evoked potentials, electroencephalogram, CT-scan, lumbar puncture or MRI.

The triggering cause should be treated if known. Relative rest in a quiet environment, sedatives, anti-emetics, analgesics or non-steroidal anti-inflammatory drugs, triptans and/or ergotamine are recommended.

Bibliographic references
  1. Carrie Elizabeth Robertson. Vestibular migraine. UpToDate. Aug 10, 2015.
  2. Furman JM, Marcus DA, Balaban CD. Vestibular migraine: clinical aspects and pathophysiology. Lancet Neurol 2013; 12:706.
  3. Von Brevern M, Neuhauser H. Epidemiological evidence for a link between vertigo and migraine. J Vestib Res 2011; 21:299.
  4. Mark F. Walker, Robert B. Daroff. Mareo y vértigo.Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición. 148:151.
  5. Javier Chacón Martínez , Jorge Alberto Jiménez Antolín, José Antonio Garrido Robres. Mareos y vértigos en urgencias. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010. 545:552
  6. Murdin L, Chamberlain F, Cheema S, et al. Motion sickness in migraine and vestibular disorders. J Neurol Neurosurg Psychiatry 2015; 86:585.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

  • Spinning sensation


  • Difficulty standing up due to unsteadiness


  • Involuntary, repeated eye movement


  • Headache


  • Difficulty coordinating movements

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
If it is accompanied by seizures
Double vision
Difficulty talking
Hearing loss
Vomiting

Self-care

Take over-the-counter analgesics and check with your general practitioner to discuss other treatments.
Consume antiemetics if vomits are present.
Lay in a dark and quiet room.
Use good lighting in the home.
Sit down immediately whenever you feel dizzy.
Check your symptoms and get a pre-diagnosis