Vestibular migraine is a common cause of recurrent dizziness, motion sensitivity, imbalance, and vertigo. People may describe the episodes as feeling dizzy, rocking, floating, spinning, off-balance, or visually overwhelmed. A person can have vestibular migraine even when headache is mild or absent during the dizzy episode.
Common symptoms
- Episodes of spinning or rocking dizziness
- Motion sensitivity
- Visual sensitivity in stores, crowds, or while scrolling
- Imbalance or a floating sensation
- Nausea
- Light or sound sensitivity
- Headache before, during, after, or sometimes not at all
How is vestibular migraine diagnosed?
There is no single test that proves vestibular migraine. Diagnosis is based on the symptom pattern, migraine history, episode characteristics, and exclusion of other causes. Vestibular testing may be useful when clinicians need to determine whether an inner-ear disorder is also present.
How is it different from BPPV?
BPPV usually causes very brief episodes triggered by specific head positions and produces characteristic positional eye movements. Vestibular migraine can last much longer and may be triggered by motion, visual stimulation, stress, sleep disruption, hormonal changes, or other migraine triggers. Some people have both conditions.
Treatment
Treatment is individualized and may include migraine lifestyle management, medications prescribed by a medical provider, vestibular rehabilitation, and management of specific triggers. Patients with persistent symptoms often benefit from coordinated care among audiology, ENT, neurology, primary care, and physical therapy.
When to seek urgent care
New severe dizziness with weakness, facial droop, difficulty speaking, inability to walk, severe sudden headache, chest pain, fainting, or other acute neurologic symptoms requires urgent evaluation rather than assuming migraine.
Learn about vestibular testing at Merit Hearing or contact us with questions about evaluation.