From Our 2008 Archives

Janet Jackson's Vestibular Migraines: FAQ

Questions and Answers About Jackson's Vestibular Migraines

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 15, 2008 -- Janet Jackson has a "rare form of migraine called vestibular migraine or migraine-associated vertigo," according to a statement released by her publicists.

Those migraines prompted Jackson to cancel several recent concert dates, but since then, she's gotten a thorough medical examination and is being treated for her migraines. She's getting her "Rock Witchu" tour back on track, starting with tonight's show in Washington, D.C.

"She's feeling much better and is ready to hit the road again to finish the tour," Janet's manager, Kenneth Crear, says in a news release.

What are vestibular migraines? How do they differ from other migraines, and how are they treated?

For answers, WebMD spoke with two headache specialists:

  • Merle Diamond, MD, co-director of the Diamond Headache Clinic in Chicago and director of the inpatient headache unit at Chicago's St. Joseph Hospital
  • Morris Maizels, MD, a family practitioner with Kaiser Permanente in Woodland Hills, Calif.

Diamond and Maizels aren't treating Jackson.

What is a vestibular migraine?

It's an episode of vertigo before and during migraine, says Maizels. He explains that "vestibular" refers to the part of the inner ear that controls balance, and that vertigo is dizziness where there is a hallucination of movement.

Vertigo "may feel like a spinning sensation, or you may feel like you're on a boat or just came off a boat," Maizels tells WebMD. He adds that the vertigo "can be more disabling than the headache itself" and can happen before the migraine starts.

But a vestibular migraine isn't just about feeling dizzy and having a migraine. "Almost anyone with migraine may get dizzy, and that doesn't mean you have vestibular migraine," Diamond tells WebMD.

She says the symptoms of vestibular migraine also include other symptoms, such as nausea, fainting, abnormal eye movements, hearing loss, and weakness in the arms and legs. "It's way more than [being] dizzy," Diamond says.

How would a vestibular migraine affect Jackson's performance?

"Having lights flash at you, dancing ... I've never been to a Janet Jackson concert, but I'm assuming that the activity involved and doing that particular concert would be a big deal," says Diamond.

Jackson had wanted to resume her tour earlier, "but she continued to suffer from vertigo and could not perform," Crear says. "She's a world-class entertainer and needs to be at the top of her game to give her fans the show they expect."

What causes vestibular migraine?

"It used to be thought to be due to a loss of circulation to the back of the brain, but now we believe it's a neurologic abnormality in the functioning of the back of your brain," says Diamond.

How are vestibular migraines treated?

No drug specifically treats vestibular migraines, but there are drugs that can treat vertigo and migraine separately.

Diamond says taking preventative migraine drugs may help curb vestibular migraines. But Maizels says it's possible for vestibular migraine patients to still get vertigo symptoms if they're only taking migraine drugs.

"I've found folks with vestibular migraines are more difficult to treat," says Maizels.

How common are vestibular migraines?

Vestibular migraines are "uncommon," says Maizels. Diamond calls them "rare" and estimates that only one or two in a thousand migraine patients have vestibular migraines.

Is there an age when vestibular migraines typically start?

Most people are diagnosed in their late teens or early 20s, "but it can happen later on in life," says Diamond. No information is available on whether Jackson's vestibular migraines are new or a flare-up of an existing condition.

"If this suddenly occurs out of the blue and you're over 40, you need to be seen by your doctor and they need to make sure that there's nothing else going on," says Diamond.

SOURCES: News release, W&W Public Relations. Morris Maizels, MD, department of family medicine, Kaiser Permanente, Woodland Hills, Calif. Merle Diamond, MD, co-director, Diamond Headache Clinic, Chicago; director, Inpatient Headache Unit, St. Joseph Hospital, Chicago.

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