Vestibular Migraine Diagnosis

Vestibular Migraine Diagnosis

In clinical practice the association of vertigo and migraine is of common observation. Vestibular Migraine is a common variant of migraine, resulting in recurrent vestibular symptoms in association with migraine features.

The diagnosis is made mainly by clinical history but here are diagnostic criteria for both definite and probable vestibular migraine. This is from the 3rd edition of the International Classification of Headache Disorders (ICHD-III), published in 2013.

Definite Vestibular Migraine:

A. At least five episodes with vestibular symptoms of a moderate or severe intensity, lasting 5 min to 72 h.

B. Current or previous history of migraine with or without aura according to the International Classification of Headache Disorders (ICHD).

C. One or more migraine features with at least 50% of the vestibular episodes:

• Headache with at least two of the following characteristics: one-sided location, pulsating quality, moderate or severe pain intensity, aggravation by routine physical activity

• Photophobia and phonophobia

• Visual aura

D. Not better accounted for by another vestibular or ICHD diagnosis

In order to diagnose probable vestibular migraine, only one of the criteria B or C must be observed.

Patient symptoms

Symptoms accompanying migraines are usually:

  • Nausea

  • Phonophobia

  • Photophobia

  • Vomiting

  • Lightheadiness

  • Visual or other auras

Patients reporting nausea and vomiting during headaches more frequently experienced the same symptoms during vertigo.

Overall, it is still challenging to confirm migraine from vestibular origin.

If you think your migraines are possibly from vestibular origin, speak to your neurologist or doctor. Or, feel free to reach out to us and determine if our Vestibular therapist, Dr. Danielle Vaughan, can help with your symptoms!


We find a close correlation between neck pain and headaches too so reach out to us if you are having neck pain associated with your headaches too!