La migraine vestibulaire : causes, symptômes et traitements

Vestibular migraine: causes, symptoms and physiotherapy treatments

Sep 01, 2023

Vestibular physical therapy can help reduce the frequency and severity of vestibular migraine attacks

What is vestibular migraine?

Vestibular migraine is a neurological condition that combines two types of symptoms: migraine symptoms and vestibular symptoms. Patients with this condition often describe their symptoms as dizziness , balance problems , and severe headaches . This condition, also called migraine associated with dizziness, can be particularly debilitating and affect patients' quality of life .

Vestibular symptoms, including dizziness and balance problems, are often reported by patients before the onset of headaches. These symptoms can last from a few minutes to several hours , and sometimes even up to several days. It is also common for vestibular symptoms to occur without the headaches typical of migraine.

Vestibular migraine is a complex condition that can be difficult to diagnose. It requires a detailed clinical evaluation, including vestibular and neurological tests, as well as review of the patient's medical history and symptoms. Each case is unique and requires a personalized treatment approach.

Physical therapy , a field of rehabilitation focused on improving the body's mobility and function, has been identified as a potential treatment option for vestibular migraine. In the following sections, we will explore in detail how physical therapy can help patients with this condition.

Symptoms of vestibular migraine

Vestibular migraine is a specific variant of classic migraine . The symptoms of vestibular migraine are distinguished from those of classic migraine by a strong component of dizziness and balance disorders. Here is a detailed comparison of the symptoms of these two types of migraines:

Symptoms Classic Migraine Vestibular Migraine
Headache Very common May not be present
Sensitivity to light and noise Common Common
Dizziness Rare Very common
Balance disorders Rare Common
Nausea Common Common

It is crucial to note that, despite some similarities, the presence of dizziness and balance disorders is much more frequent and intense in vestibular migraine than in classic migraine. This is why the management of vestibular migraine requires a different approach, where physiotherapy plays an essential role .

Vestibular migraine represents approximately 1% of migraine cases

Limitations of current treatments for vestibular migraine

Vestibular migraine is a condition that can be confusing and debilitating for many patients. Unfortunately, currently available treatments have their limitations. Although medications and surgeries may help some patients, they may not work for everyone, and they often have unwanted side effects. Additionally, they do not treat the underlying cause of vestibular migraine, but only manage the symptoms.

Medications are often the first line of treatment for vestibular migraine. They can help reduce the frequency and severity of migraine episodes. However, they don't work for everyone and may have unwanted side effects , such as drowsiness, dizziness, and nausea. Additionally, some patients may develop a tolerance to the medications, meaning they will need to increase the dose to achieve the same effect.

Surgical interventions , such as neurostimulation, may be considered for cases of vestibular migraine resistant to drug treatment . However, these interventions carry risks and are not guaranteed to be successful. Additionally, they can be expensive and are not always covered by insurance.

Finally, current treatments for vestibular migraine do not take into account the holistic aspect of health. They focus on treating specific symptoms, but often neglect the patient's overall well-being. Many patients also suffer from co-occurring disorders, such as anxiety and depression, which can be exacerbated by the inability to effectively manage their vestibular migraine symptoms.

It is clear that new approaches are needed to help patients with vestibular migraine. This is where physiotherapy comes in.

Physiotherapy: an alternative solution

Physiotherapy, often considered an alternative treatment, plays an essential role in the management of vestibular migraine. This movement-focused treatment approach can provide significant relief to patients suffering from this condition.

Vestibular migraine, also known as migraine associated with dizziness, is characterized by intense headaches accompanied by vestibular symptoms such as dizziness, unsteadiness, and coordination problems. These symptoms can disrupt daily life , making it difficult to carry out simple, common tasks.

So how can physical therapy help these patients?

  1. Improved balance and coordination: Physical therapists use targeted exercises to improve balance and coordination, two aspects often affected by vestibular migraine. This improvement may help reduce the frequency and intensity of episodes of dizziness.
  2. Pain management: Physical therapy uses gentle manipulative techniques to relieve muscle tension that can contribute to migraine pain. Physical therapists can also teach patients relaxation and breathing techniques to help manage pain.
  3. Improved physical function: Physical therapists work with patients to improve their strength and flexibility, which can help prevent future migraine attacks. They can also help correct poor postures that can contribute to migraine pain.

It is important to note that the effectiveness of physical therapy may vary from patient to patient. However, several studies have demonstrated its effectiveness as an integral part of a comprehensive treatment plan for vestibular migraine.

It is by combining physical therapy with other treatments, such as medications and lifestyle modifications, that patients can hope to achieve the best possible relief.

In sum, physical therapy can offer relief not only from the physical symptoms of vestibular migraine, but also improve patients' overall quality of life. It is therefore essential to consider this therapeutic approach in the treatment of vestibular migraine.

Migraine and physiotherapy

How does physiotherapy work to treat vestibular migraine?

Physical therapy, also known as physiotherapy, is a non-drug therapeutic intervention that can play a crucial role in the treatment of vestibular migraine . It aims to improve bodily function and mobility through physical exercise, manual mobilization, education and counseling.

Vestibular migraine is a neurological condition that causes dizziness and severe headaches . People with this condition may also experience symptoms such as nausea, vomiting, imbalance, sensitivity to light and noise. Here is how physical therapy can help treat this condition:

Strengthening balance and coordination

Physical therapists use a variety of techniques to help improve balance and coordination, which are often affected by vestibular migraine. This may involve core stabilization exercises, single-leg balance exercises, eye and head coordination exercises, and walking exercises.

Improved posture

Poor posture can exacerbate vestibular migraine symptoms. Physical therapists can help improve posture through corrective exercises and advice on how to maintain correct posture during daily activities.

Symptom management

Physical therapy may also play a role in managing vestibular migraine symptoms. For example, it can help manage headaches through relaxation, breathing and neck and head mobilization techniques.

Effectiveness of physiotherapy in the treatment of vestibular migraine

Several studies have shown that physical therapy can be beneficial for patients with vestibular migraine. One study found that 90% of patients who completed a physical therapy program showed significant improvement in their symptoms . Another study showed that physical therapy can help reduce the frequency and intensity of headaches in patients with vestibular migraine.

In conclusion, physical therapy can play an important role in the treatment of vestibular migraine. It can help improve balance and coordination, improve posture and manage symptoms. However, each patient is unique, and the treatment plan must be tailored to their specific needs.

The benefits of physiotherapy for patients suffering from vestibular migraine

Vestibular migraine is a neurological condition that combines the symptoms of a classic migraine with balance and coordination problems. Seizures can be disabling, making daily tasks difficult and affecting quality of life. Fortunately, physical therapy can play a key role in the management of this condition. Here's how it can help patients:

Improved balance and coordination

Patients with vestibular migraine may experience balance and coordination problems during and after attacks. The physiotherapist offers specific exercises to improve these abilities. The exercises are tailored to each patient , depending on the severity of symptoms and individual needs. They can include simple movements like walking in a straight line or more complex exercises involving balls and targets.

Reduction of migraine symptoms

Physical therapy can help improve some migraine symptoms, such as headaches and sensitivity to light and noise. It may include relaxation and breathing techniques , as well as stretching and muscle strengthening exercises. These techniques can help reduce muscle tension, which is often associated with migraine attacks.

Reduction in frequency and severity of seizures

By improving balance, coordination and alleviating migraine symptoms, physical therapy can help reduce the frequency and severity of attacks . This can help patients lead more normal lives and improve their quality of life.

In short, physiotherapy offers a series of benefits for patients who suffer from vestibular migraine. By working closely with each patient, the physical therapist can develop an individualized treatment program that aims to improve balance and coordination, alleviate migraine symptoms , and reduce the frequency and severity of attacks. It is a therapeutic approach that can play an essential role in the management of this condition.

Physiotherapy exercises recommended for patients with vestibular migraine

Physiotherapy is an effective therapeutic approach for the treatment of vestibular migraines. It aims to stabilize the vestibular system, improve balance and reduce the symptoms associated with this pathology. Here are some physiotherapy exercises that have been shown to be effective for patients suffering from vestibular migraines.

Vestibular rehabilitation exercises

Vestibular rehabilitation exercises are designed to stimulate and re-educate the vestibular system. They include:

  • Gauze exercises : These exercises involve tracking head movements with the eyes, while remaining focused on an object. They help improve eye-motor coordination.
  • Head positioning exercises : These exercises help reduce feelings of dizziness by retraining the vestibular system to adapt to head movements.
  • Walking exercises : These exercises aim to improve balance and coordination, especially when moving.

Relaxation and breathing exercises

Vestibular migraines can also be managed by learning relaxation and breathing techniques. These exercises help relieve stress and tension, which can often intensify migraine symptoms. These techniques may include:

  • Deep breathing : This technique involves taking slow, deep breaths, which can help relax the body and reduce pain.
  • Progressive muscle relaxation : This technique consists of gradually tensing and relaxing the different muscle groups of the body. This can help relieve muscle tension and reduce migraine symptoms.

It is important to note that each patient is unique and the approach to physical therapy should be personalized based on each individual's specific needs and symptoms. Physical therapists trained in this area can provide detailed instructions and supervise exercises to ensure their effectiveness and safety. Additionally, a multidisciplinary approach including medication, physical therapy, and psychological support can often provide the best results for patients suffering from vestibular migraines.

How to choose a physiotherapist for the treatment of vestibular migraine

Choosing a physical therapist to treat your vestibular migraine can seem like a challenge, especially if you're not sure which criteria are essential. However, by keeping some key points in mind, you can make this process less complex and more efficient.

It is important to note that physiotherapy is a regulated profession. Physiotherapists must be registered with the Order of Physiotherapists in their country of practice. They must also complete continuing education to maintain their registration. Therefore, make sure that the specialist you choose is well registered.

Experience with vestibular migraine

It is essential that the physiotherapist has experience in treating vestibular migraine . This type of migraine has specific symptoms and requires a specialized treatment approach, so having a therapist who is familiar with this disorder is a significant advantage.

You can ask how many vestibular migraine patients the therapist has treated and what their success rate has been.

Treatment approach

Physical therapy uses a variety of techniques to help manage and treat vestibular migraine symptoms. Make sure the physical therapist you choose uses an evidence-based treatment approach and is up to date with the latest research in this area. Additionally, the therapist should be able to personalize the treatment plan based on your specific needs.


Good communication is essential when working with a physical therapist. The healthcare professional should be able to clearly explain your condition, your treatment plan and your progress. Additionally, it should be accessible and open to questions and concerns you may have.

In summary, when looking for a physical therapist to treat your vestibular migraine, be sure to consider their professional registration, experience with vestibular migraine, treatment approach, and communication skills. By considering these factors, you will increase your chances of finding a qualified professional who can help you manage your migraines effectively.

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