Motion sickness and an overall reduced tolerance to movement is often reported in patients who suffer from migraine. The recommendation is to treat the migraine first. When migrainous episodes are under control, patients benefit greatly from vestibular rehabilitation aimed at increasing motion tolerance. Identifying and avoiding triggers is one way to keep migraines under control as well reduce the number of episodes. Triggers include stress, foods (e.g., cheese), alcohol (e.g., red wine), smells. Preventative medications can also be used to avoid migraine episodes from happening.

Motion sickness and an overall reduced tolerance to movement is often reported in patients who suffer from migraine. The recommendation is to treat the migraine first. When migrainous episodes are under control, patients benefit greatly from vestibular rehabilitation aimed at increasing motion tolerance. Identifying and avoiding triggers is one way to keep migraines under control as well reduce the number of episodes. Triggers include stress, foods (e.g., cheese), alcohol (e.g., red wine), smells. Preventative medications can also be used to avoid migraine episodes from happening.

Some of the vestibular rehabilitation activities done under supervision are taught to clients to practice at home in a safe and controlled manner. These activities include:

• motion-sensitivity exercises such as rolling in bed, sitting to standing, and walking while turning the head
• many different balance exercises
• visual or gaze exercises
• “target shooting”, that is keeping the head still while moving the eyes, or moving the head and keeping the eyes still
• the Epley maneuver to re-position ear crystals

A treatment for visually-stimulated vertigo consists of watching things in motion. Repeatedly watching full-screen versions of the NED Leader (right and left) video clips on YouTube is suggested. When you get the feeling that you want to look away, watch for three to five seconds longer. Becoming accustomed to doing the tai chi “cloud hands” movement follows the same principle; it habituates your brain to the movement of your hands.

Below are some optokinetic exercise videos.

This is a basic one:

• http://dizziness-and-balance.com/treatment/rehab/mdd/okn.php?arg1=50 (use the arrow keys to start the movement and control the speed)

These two are harder:

• https://www.youtube.com/watch?v=iwm4acc3wRc&t=13s
• https://www.youtube.com/watch?v=-7DqDnBNmfY

Once you are used to these, try this one:

• https://www.youtube.com/watch?v=YWaGzTFRlWg

The following playlists compile complex exercises:

• https://www.youtube.com/channel/UCwDX4UUxFH7BZhs2gFYw6oA/playlists

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