Vestibular Migraine

Vestibular migraines are a combination of headaches, migraines, dizziness and vertigo.

  • Migraines come in a wide assortment of categories (e.g., classic, atypical, cluster, etc) and involve a range of symptoms:
  • nausea
  • visual disturbances (e.g., aura, snow, stars, etc)
  • autonomic dysfunction
  • vestibular dysfunction (e.g., dizziness or vertigo)

It can be terribly frustrating for people experiencing vestibular migraines to get an accurate diagnosis. Some specialists think that the two symptoms are unrelated. Other people are diagnosed with Meniere’s disease, BPPV (benign paroxysmal positional vertigo), end-lymphatic hydrops, and so forth.

People can spend years (and thousands of dollars) searching for the “right diagnosis” so that you can get the “right treatment.” The truth of the matter when it comes to vestibular migraines is that the name of your condition is less important than discovering the cause. When you discover the cause, whatever name you choose to call it is far less important.


The REAL nature of Vestibular Migraines

Here is an important thing your neurologist probably didn’t tell you. When you experience two or more different symptoms, they are probably connected.

Vestibular migraines are no exception to this rule. Every human being has different anatomy, genetics and also neurology. Indeed, we are all similar, but not identical.

What this means is that two people can have the same underlying condition, but the symptoms express themselves in different ways.

One person might experience symptoms consistent with vestibular migraines (head pain with dizziness or vertigo). Another person might experience symptoms consistent with ocular migraines (head pain with visual disturbances). And other person might experience symptoms consistent with dysautonomia (head pain with anxiety and heart palpitations).

The common theme here is what is known as the craniocervical junction. It is the area where your skull meets your cervical spine (neck).


The Craniocervical Junction and Vestibular Migraines

The craniocervical junction (CCJ) includes a variety of structures involved with vital life function:

  1. The brainstem (aka medulla). Your brainstem coordinates all your vital life functions. The brainstem also processes your sense of balance and equilibrium.
  2. The cerebellum. Your cerebellum is also intricately linked to your sense of balance, coordination, gait and muscle tone in all parts of your body. It is also a gateway that promotes the health and function for the higher executive centers of your brain as well (i.e., the ability to think and regulate your mood).
  3. The vagus nerve. The vagus nerve connects your brain to all of your vital organs. It is also linked with your eyes and regulates blood flow and inflammation in your brain.   
  4. The atlas (C1) vertebra. This top bone in your neck has a profound impact on the various muscles, ligaments and blood vessels that supply your brainstem.

In this way, a problem in your neck has the potential to affect all of these higher brain centers, which can lead to vestibular migraines as well as a host of other health problems.


Why are all my tests normal if I have an Atlas misalignment?

The role of atlas alignment, motion and stability is a key factor that can lead to vestibular migraines. Unfortunately, it is commonly under-diagnosed. Here is why.

  • Blood tests are good for finding inflammation and chemical imbalances in the body. However, an atlas misalignment is a physical problem. Thus, it can only be discovered (and treated) by a physical approach.
  • Standard X-rays are good for finding arthritis and broken bones. However, because every human being has slightly different anatomy, unless special views are taken in an upright position, the position of the atlas cannot be clearly determined.
  • Standard CT scans and MRIs are good for finding brain bleeds, tumors and infections. However, because they are taken in a recumbent position (i.e., lying down), they seldom reveal the disrelationship of the atlas vertebra relative to the skull and spinal cord.

In summary, it takes very specific testing to determine if you actually have an atlas misalignment that can be  contributing toward your vestibular migraines. The good news is that these tests are not hard to find, nor do they cost thousands of dollars. You just need to know where to look.


A Different Approach for Vestibular Migraines

The gold standard tests for an atlas misalignment is a digital articular X-ray (DAX) or cone-beam CT (CBCT) scan. In brief, these tests show the exact location, directions and degree of atlas misalignment in your neck. The difference is that they are taken from non-standard angles based on your own anatomy.

As it relates to vestibular migraines is that the atlas misaligns forward relative to the skull 80% of the time. The reason this is important is because many conventional and natural forms of treatment for vestibular migraines (e.g., chiropractic, physical therapy, osteopathy and massage) typically treat the atlas from back-to-front. What the research shows is that the vast majority of the time, the atlas needs to be treated from front-to-back!

This is one of the key differences in the Blair technique and how it can help people with vestibular migraines. The Blair technique is a special division of upper cervical specific chiropractic that does not use any twisting, popping or cracking the neck. It is a natural approach that uses these types of advanced diagnostic tests to design a treatment just for you to help restore the normal alignment, motion and stability of the atlas vertebra. In this way, the Blair technique has a long history in helping people with a variety of conditions including vestibular migraines.

Even if you have tried general chiropractic to help your vestibular migraines, the Blair technique is different. If you are looking for a chiropractor in Spokane, visit our home page more information. To schedule a new patient appointment with our Mead (north Spokane) or South Hill offices, complete a new patient request form here or call us direct at 509-315-8166.