Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Migraine Associated Dizziness (Vestibular Migraine)

Migraine is a neurological phenomenon that can manifest a variety of signs and symptoms including headaches, visual changes/blindness, limb weakness, sensory disturbances (numbness/tingling), mid-face pain/pressure/nasal congestion mimicking sinusitis and dizziness. Specific symptoms are likely based on the region(s) of the brain involved during migraine. Dizziness from migraines can occur independent of headaches and typically include positional vertigo (with negative Dix-Hallpike results for Benign Paroxysmal Positional Vertigo), chronic imbalance, motion sensitivity or sometimes-prolonged vertigo (recurrent and lasting from several hours to three days). Vertigo is the feeling that you or the world is spinning when you are not actually moving.

There is no test specific for the diagnosis of vestibular migraine. Therefore, a general medical evaluation by your internist must be performed to rule out cardiovascular, metabolic and medication-related sources prior to being seen by Ear & Hearing personnel at the Center for Neurosciences. Our approach to patients with migraine associated dizziness is to take a careful otologic/neurotologic medical history, perform inner ear testing to rule out audiologic and vestibular dysfunction, obtain MR brain imaging with Internal Auditory Canal protocol to rule out retrocochlear structural pathologies and prescribe first-line anti-migraine medications (for up to three months) to patients that appear to have this diagnosis. Identifying and eliminating food triggers as well as personal stress management are also vital to treatment success. Should there be a combination of inner ear dysfunction and migraine contributing to an individual patient’s symptoms, both may be managed separately.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care.
  • Differentiating inner ear dysfunction from central (brain) pathologies such as migraine is often difficult. E&H provides comprehensive functional assessment of the ear prior to diagnosing or treating vestibular migraine. Appropriate referral to Neurology is also available within the umbrella of the Center for Neurosciences.