In short
Vestibular migraine causes episodes of vertigo, dizziness or imbalance in people with migraine, often with sensitivity to light, sound or motion, and sometimes without any headache. It’s one of the most common causes of recurrent vertigo. Migraine prevention, lifestyle changes and vestibular rehabilitation help.
On this page
What is vestibular migraine?
Vestibular migraine is a form of migraine that causes episodes of vertigo or dizziness. The vestibular system, in the inner ear and brain, controls balance and spatial orientation. In vestibular migraine, migraine affects how this system works. It’s one of the most common causes of recurrent vertigo, though it’s often missed.
Symptoms
- Vertigo: a feeling that you or the room is spinning or moving
- Dizziness or unsteadiness, especially with head movement
- Motion sensitivity, such as feeling worse in cars or busy places
- Sensitivity to light and sound
- Headache, though many episodes happen without headache
- Nausea
Episodes can last from minutes to days.
Headaches taking whole days away?
Talk it through with an Australian doctor online. No referral needed.
How it’s diagnosed
There’s no test for vestibular migraine. Doctors use criteria from the International Headache Society and the Bárány Society, updated in 2022. They include:
- at least five episodes of moderate or severe vestibular symptoms lasting five minutes to 72 hours
- a current or past history of migraine
- migraine features, such as headache, light and sound sensitivity or visual aura, in at least half of the episodes
- no better explanation from another condition
Doctors also check for other causes of vertigo, such as benign paroxysmal positional vertigo (BPPV), Ménière’s disease, inner ear inflammation and, rarely, stroke. Hearing tests or balance tests may be arranged.
Treatment
- Migraine lifestyle measures: regular sleep, regular meals, hydration, exercise and stress management
- Trigger awareness: sleep loss, stress, hormones, bright lights and some foods for some people
- Vestibular rehabilitation: exercises guided by a vestibular physiotherapist to reduce dizziness and motion sensitivity
- Medicines for attacks or prevention, which a GP or neurologist can talk through
See migraine relief without medication for practical steps.
When to get urgent help
Call 000 for sudden vertigo with a new severe headache, double vision, trouble speaking or swallowing, weakness or numbness, or inability to walk, which can be signs of stroke.
When to see a GP
See a GP for recurrent episodes of dizziness or vertigo, especially if you have migraine or a family history of it.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Lempert T, Olesen J, Furman J, et al. Vestibular migraine: Diagnostic criteria1. J Vestib Res. 2022;32(1):1-6.
- Ferrari MD, Goadsby PJ, Burstein R, et al. Migraine. Nat Rev Dis Primers. 2022;8(1):2.
- . Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
- Migraine & Headache Australia. Migraine & Headache Australia.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.