Why Me?
Why Do I Have Vestibular Migraine?
Have you been living a relatively normal life and then all of the sudden, out of nowhere, you get hit with a vertigo attack and wonder where this is all coming from? Well , its part related to your genes and part related to your threshold.
In this article, we will discuss what individual thresholds are and why some people experience vestibular attacks at all or more frequently than others.
Patients with vestibular migraine have a genetic predisposing, given the migraine gene which is passed on from family members. The migraine gene is passed on easily and even having one close family member with migraine puts you at risk. The presence of migraines lowers your threshold to handle vestibular insults. These people are often more susceptible to motion sickness- making it hard to tolerate boat rides or sitting in the back seats of cars. Some, also report never having a headache in their life, but upon a deeper dive you can often find symptoms of migraine that were never noticed- irrespective of headaches. It is interesting to note that for those with migraine- vertigo symptoms occurred on average 5 years after migraine onset. So you may have been experiencing migraine for quite some time before your vertigo attacks began.
Here is a graph showing the concept of threshold and when they are triggered.
Here is how we read the graph:
Starting from the bottom, if for example, you have a genetic predisposition to the migraine gene and your life is composed of a variety of the listed triggers such as stress, poor sleep, skipped meals, and hormonal changes, your threshold is reached far more quickly than if you just had a genetic predisposition to the gene without the triggers. What this means for you is that maybe you have the migraine gene or not and all of the sudden your life brings you stress and the cascade of events to follow, you will reach your individual threshold level sooner and experience an attack. This threshold bar can be raised or lowered depending on internal and external factors or medications. Lets say you start eliminating trigger foods and work on some poor sleep habits, you will in theory raise your threshold bar, making it harder to reach and subsequently experience an attack.
So the question of why me, why now all comes back to the threshold bar and whats going on in your life. You need to evaluate the different triggers which I discuss in another article here and understand that a combination of the triggers is what determines your threshold bar before you experience an attack. Work on correcting those triggers and if you happen to have the migraine gene-which you unfortunately cant get rid of- it will at the very least just make it harder to hit the bar and experience an attack.