A little-known condition is emerging behind recurring dizziness often mistaken for inner ear crystals shifting or a neck hernia. Prof. Dr. Osman Müftüoğlu has warned about the hidden danger, saying that although it is common in the community, it can go undiagnosed for years because it does not always cause headaches.
Do not be reassured just because you do not have a headache. The dizziness could be caused by a very different form of migraine than expected.
When most people think of migraine, they picture throbbing head pain, a dark room and sensitivity to light. But migraine can sometimes wear a very different mask. Your head may not hurt at all, yet the world starts spinning.
You may feel unsteady while walking, unable to look at a computer screen, or as if you are still moving even after parking your car. This is known as vestibular migraine.
Unfortunately, this condition is often mistaken for an ear disorder, a neck problem, anxiety or "dislodged ear crystals." Patients may spend months, even years, visiting different doctors.
In many cases, however, the problem is not in the ear but in the brain's balance centers becoming overly sensitive.
This is the most surprising feature of vestibular migraine: there may be no headache at all. The most prominent symptoms are dizziness and balance problems. As a result, diagnosis is often delayed.
Patients describe the dizziness as feeling like they are rocking on a boat, the ground is shifting, the room is spinning, or they are losing balance while walking.
This may be accompanied by sensitivity to light and sound, nausea, worsening with movement, and mental fatigue.
Research suggests that about 3% of the population has vestibular migraine, though experts believe the true rate may be even higher. For this reason, specialists describe it as "one of the most common conditions you have never heard of."
One of the most striking points is that many patients are not correctly diagnosed.
Many move between ENT clinics, neurology departments, emergency rooms and other specialties for long periods before receiving the right diagnosis.
Today, migraine is no longer seen only as a headache disorder. It is increasingly viewed as a temporary disruption in how the brain processes sensory information.
During a migraine attack, the nervous system may overreact even to normal stimuli.
Light appears brighter, sounds seem louder, and movement becomes far more disturbing. If this hypersensitivity affects the brain's balance centers, vestibular migraine can result.
The three biggest triggers
These may also be compounded by intense work schedules, long journeys, hormonal changes and sensory overload.
In other words, the brain may at times say "enough" and overload the balance system.
People with a history of migraine are at higher risk. However, vestibular migraine can also appear in people who have not suffered headaches for years.
It is more common in women. Anxiety, depression, previous head trauma and younger age are also among the risk factors.
Can it be treated? Yes. But there is no single miracle drug. The foundation of treatment includes regular sleep, stress control, healthy eating and personalized preventive medications.
Some patients may also benefit from supplements such as magnesium, riboflavin (vitamin B2) and coenzyme Q10.
Recent studies also suggest that CGRP inhibitor drugs, developed for migraine treatment, are beginning to show promising results in vestibular migraine as well.
However, a neurology specialist should always decide which treatment is best for each patient.
