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Vestibular Migraine

What is Vestibular Migraine?

Vestibular migraine is a common cause of dizziness and vertigo. It is a type of migraine that can make you feel like you are spinning, off balance, or sick with motion. Some people also get headaches, but many do not.

Symptoms can last for minutes, hours, or even days. They may come and go over time. Vestibular migraine is real, common, and treatable.

What is Happening in My Body?

Vestibular migraine affects the parts of your inner ear and brain that help with balance and movement. When this happens, those signals can get mixed up. That can make you feel dizzy, wobbly, or like things are moving when they are not.  This can make your brain more sensitive to movement, light, sound, and busy visual patterns.

Because of this, you may feel:

  • Spinning or vertigo
  • Dizziness
  • Rocking or swaying, even when still
  • Unsteadiness or balance problems
  • Sensitivity to light, sound, or motion
  • Nausea or vomiting
  • Head pressure or headache (but not always)
  • Trouble focusing or “brain fog”

It is important to know:

  • You did not cause this
  • These symptoms are real 
  • Many people improve with the right care
  • Symptoms can change over time

How is Vestibular Migraine Diagnosed?

Vestibular migraine is diagnosed mainly by listening to your history. Your provider looks for a pattern of dizziness linked to migraine features and rules out other causes.

What Your Provider May Ask:

  • Do you have a history of migraine headaches or migraine symptoms?
  • What does your dizziness feel like?
  • How long do your symptoms last?
  • What triggers your symptoms, such as stress, poor sleep, screens or motion?
  • Do light, sound, or visual patterns make symptoms worse?
  • How often do symptoms happen?
To prepare you for your visit, it may be helpful to think about, and write down, your answers to these questions.

Common Tests Used to Confirm Diagnosis

It is important to know: there is no single test for vestibular migraine. Your provider makes the diagnosis by looking at your symptoms, your health history, and your exam. Other tests may be done to rule out other causes.

  • Hearing test: checks your hearing.
  • Balance testing (ENG/VNG): checks how well your balance system is working.
  • Neurological exam: checks eye movements, reflexes, and coordination.
  • MRI or CT scan: may be used to rule out other problems, but not to diagnose vestibular migraine.

An example of eye movements exam being performed by a trained clinician

How is Vestibular Migraine Treated?

Treatment focuses on calming the body, lowering triggers, and helping you better tolerate movement and balance tasks. Most people need more than one type of treatment, not just one.

Common Treatment Options:

  • Education and Trigger Management – Learning about vestibular migraine can help you understand your symptoms and feel more in control. It can also help to learn what triggers your symptoms. Common triggers include poor sleep, stress, dehydration, and skipping meals. Some people also feel worse after certain foods or drinks, such as caffeine, chocolate, alcohol, aged cheese, MSG, artificial sweeteners, and processed meats.
  •  Vestibular Rehabilitation Therapy (VRT) – Vestibular rehabilitation is a type of therapy with special exercises. These exercises help your brain better handle balance and motion signals.
  •  Lifestyle Changes – Healthy daily habits can help many people. These include regular sleep, eating meals on time, drinking enough water, exercising, managing stress, and limiting screen time.
  • Medicines and Supplements – Some people improve with migraine medicines that help prevent symptoms or give short-term relief. Certain supplements may also help, including riboflavin, magnesium, vitamin D3, melatonin, and CoQ10. Talk with your provider before starting any new medicine or supplement.

Download the SEEDS Printable PDF

This guide was made to be easy to read and use. It explains simple daily habits that may help people manage migraine symptoms, including sleep, exercise, eating, hydration, tracking symptoms, and stress. We hope it helps you feel more informed and supported as you take the next step in your care.

What Can I Expect Over Time?

Will I get better?

Many people do improve with the right diagnosis and treatment plan.

How long will it take?

Improvement is often gradual. Some people feel better within weeks, while others need months. Setbacks can happen, and do not mean treatment has failed.

Can I live a normal life?

Yes. Many people return to work, school, and activities they enjoy. Learning to manage symptoms and triggers can help you feel more confident.

When Should I Call My Provider?

Contact your provider if you have:

  • New or sudden severe headache unlike past migraines
  • Weakness, numbness, slurred speech, or vision loss
  • Fainting or loss of consciousness
  • Chest pain or shortness of breath
  • Dizziness after a head injury
  • Symptoms that are quickly getting worse or not improving

Always tell your clinician about any symptom that worries you.

Questions to Ask Your Provider:

  • Could my symptoms be vestibular migraine?
  • What triggers should I watch for?
  • Would vestibular therapy help me?
  • Do I need medication?
  • What should I do during a flare-up?
  • When should I follow up or seek urgent care?
These questions can help you get more clarity about your dizziness as well as your potential treatment. They may also give you answers that will help you plan for your daily life in the future.

Key Takeaways/Key Points to Remember

  • Vestibular migraine is a common cause of dizziness
  • Headache may or may not happen
  • Diagnosis is based on symptom patterns, not one test
  • Treatment often includes lifestyle changes, therapy, and sometimes supplements or medication
  • Many people improve with proper care

Additional Resources