VESTIBULAR MIGRAINE

MIGRAINE-RELATED DIZZINESS

 

In Brief

Vestibular migraine is a form of migraine that shows itself as attacks of dizziness, instead of or together with headache. It is one of the most common causes of recurrent dizziness and is seen especially in women. It is not a dangerous condition: by recognizing triggers and with appropriate treatment, attacks can be reduced considerably.

 

EMERGENCY WARNING: If dizziness is accompanied by difficulty speaking, double vision, numbness or weakness of the face, arm or leg, inability to walk, or the worst headache of your life, call emergency services (112 in Türkiye) even if you have been diagnosed with migraine before.

 

What Is Vestibular Migraine?

Migraine is not just a headache; it is a condition in which the brain is overly sensitive to stimuli. This sensitivity can also affect the balance system. In some people, migraine attacks appear as dizziness more than headache. The attacks do not cause permanent damage to the ear or the brain.

 

What Are the Symptoms?

• Dizziness or a swaying sensation that starts on its own or with head movement and lasts from a few minutes to a few hours, rarely up to a few days

• Throbbing headache, together with the attack or at other times

• Strong sensitivity to light and sound

• Nausea, sometimes vomiting

• Discomfort with moving visual scenes (crowds, scrolling screens, travelling in a vehicle)

• Some attacks may occur without any headache

 

Who Gets It?

It affects about 1 in every 100 people. It is several times more common in women than in men and usually starts between the ages of 20 and 50. Most people have a personal or family history of migraine. It can also occur in children.

 

What Triggers Attacks?

• Lack of sleep or irregular sleep

• Stress, or the relaxation period after stress

• Skipping meals, not drinking enough water

• Menstrual periods and hormonal changes

• Bright light, noise, strong smells

• Certain foods and drinks (these vary from person to person)

Keeping a “dizziness diary” for a while is the best way to find your own triggers.

 

How Is It Diagnosed?

There is no single test that shows vestibular migraine; the diagnosis relies mainly on what you describe. How long the attacks last, what starts them and whether migraine symptoms accompany them are the most important clues. Balance tests (VNG, vHIT), a hearing test and, if needed, an MRI are used to distinguish it from similar conditions such as Ménière’s disease or positional vertigo (BPPV).

 

How Is It Treated?

Treatment is tailored to each person and usually involves several steps:

Lifestyle: Regular sleep and meals, enough water, regular exercise and avoiding known triggers reduce attacks considerably in most patients.

During an attack: Medicines that relieve nausea and dizziness can be used for a short time. Long-term use of these medicines is not recommended.

Preventive treatment: If attacks are frequent or severe, a suitable migraine-preventive medicine may be given for several months.

Balance exercises: These help with unsteadiness and motion sensitivity that persist between attacks.

The most suitable treatment for you is decided together after an examination.

 

Frequently Asked Questions

Can I have vestibular migraine without a headache? Yes. Some attacks occur without any headache, which is why the diagnosis is sometimes delayed.

Does it cause permanent hearing loss? No. The ear may feel full during an attack, but permanent hearing loss is not expected. If there is marked or fluctuating hearing loss, other causes should be investigated.

Will it go away? Migraine can increase or decrease at different times of life. In most patients, attacks become less frequent and milder with the right treatment.

 

For physicians – detailed information and diagnostic criteria: see the Vestibology link at the top of the page (vestibology.com).

Last updated: November 2026 · Editor: Assoc. Prof. Dr. Mehmet Sürmeli · Source: Bárány Society and International Headache Society diagnostic criteria for vestibular migraine. This page is for general information only and does not replace a medical examination or diagnosis.