MAV (Migraine-Associated Vertigo): A Clear Guide

What is MAV / Vestibular Migraine?

Migraine-Associated Vertigo (often now called vestibular migraine) is a form of migraine where the main symptom is dizziness or vertigo rather than—or in addition to—head pain. It’s an accepted medical diagnosis and goes by several names, including migrainous vertigo and migraine-related vestibulopathy.

Why it matters

If you’ve ever felt the room spin, become unsteady, or suddenly nauseous without obvious reason, MAV might be the cause. Vestibular migraine is one of the common reasons people experience recurrent vertigo and is often under-recognized. Early identification helps avoid unnecessary tests and, importantly, leads to treatment that can reduce frequency and severity.

Typical symptoms

Symptoms are variable:

• Vertigo or spinning lasting from minutes to hours (sometimes up to 72 hours).
• Non-spinning dizziness, unsteadiness, motion sensitivity.
• Associated migraine features such as head pain, light/sound sensitivity, visual aura, or nausea—though headaches are not always present.

Who gets MAV?

Vestibular migraine commonly affects adults, more often women than men, and can occur at any age. Lifetime prevalence estimates vary, but it may affect roughly 1% to 3% of the population and represents a notable share of patients seen in dizziness or headache clinics.

Common triggers

Like other migraines, vestibular migraine attacks can be triggered by:

• Irregular sleep or fatigue
• Stress or anxiety
• Certain foods (e.g., aged cheese, nitrites) or alcohol
• Hormonal changes
• Visual motion (busy patterns, scrolling screens)

Avoiding or managing triggers is often a first-line strategy.

How MAV is diagnosed

There’s no single lab test. Diagnosis relies on clinical criteria (consensus criteria from the Bárány Society and the International Headache Society), a typical pattern of recurrent vestibular symptoms with a migraine history, and excluding other causes such as inner-ear disease or stroke. Tests like hearing exams, vestibular function tests, and sometimes imagine help rule out other problems.

How MAV feels in plain terms

Imagine motion sickness that comes and goes, sometimes with a headache or a halo of light sensitivity. For some people it’s a brief jolt of imbalance; for others it’s a brutal day-long episode that leaves them exhausted. Triggers and severity differ widely.

Treatment approaches

There’s no one-size-fits-all cure, but many people get meaningful relief with a combination of strategies:

1. Lifestyle & trigger control

Regular sleep, hydration, steady meals, stress reduction, and avoiding known dietary triggers are cornerstone measures. These simple steps often cut attack frequency significantly.

2. Acute symptom relief

For individual attacks, doctors may recommend medications used for migraines (pain relievers, certain anti-nausea drugs, and sometimes triptans) under supervision. Effectiveness varies, and not every migraine medicine helps vertigo symptoms.

3. Preventive medications

If attacks are frequent or disabling, preventive drugs can be tried. Options include beta-blockers (e.g., propranolol), certain calcium-channel blockers (e.g., flunarizine in some countries), antiepileptic drugs (e.g., topiramate), and some antidepressants—chosen based on your health profile and side-effect risks. Evidence quality varies, and treatment tends to be individualized.

4. Vestibular rehabilitation & therapies

Targeted vestibular rehabilitation (balance exercises) and graded exposure to motion can help, particularly once attacks are better controlled. Cognitive strategies, physiotherapy, and vision therapy may also support recovery.

Risk management & red flags

Although MAV is usually benign, sudden severe vertigo with stroke-like signs (weakness, slurred speech, severe imbalance) requires immediate emergency care. Always consult a clinician before starting or stopping medications.

Living well with MAV

Tracking triggers and attack patterns, building a stable daily routine, and working closely with a neurologist or ENT specialist who understands vestibular migraine can transform life quality. Many people see reduced attacks over months with consistent management.

Current research & outlook

Research is improving our understanding of vestibular migraine mechanisms and refining treatment choices. Recent reviews note that while evidence is limited, practical treatment plans combining lifestyle, medications, and rehabilitation are effective for many patients.

Conclusion

MAV (vestibular migraine) is a common and treatable cause of recurrent dizziness and vertigo. With the right diagnosis and a tailored plan—trigger control, targeted medication when needed, and vestibular therapy—most people can reduce attack frequency and regain control over daily life.

FAQs

1. Is MAV the same as “regular” migraine?
Not exactly—MAV centers on dizziness and vertigo, though it shares mechanisms and triggers with other migraine types.

2. Can MAV be cured?
There’s no guaranteed cure, but many people achieve long-term control and fewer attacks through combined strategies.

3. Should I get MRI or ear tests?
Sometimes—imaging and vestibular tests are used to exclude other causes. Your clinician will decide based on history and exam.

4. Are over-the-counter meds helpful?
They may help with mild attacks, but persistent or severe vertigo usually needs specialist guidance.

5. When should I see a specialist?
If dizziness is recurrent, increasing, or disabling—or if you have neurological signs—see a neurologist or ENT experienced with vestibular migraine.