Vestibular Migraine – Location, Symptoms and Treatment

Individuals who have a history of migraines can experience an episode of vertigo and is known as Vestibular Migraine. An episode of Vestibular Migraine can consist of Vestibular symptoms alone, such as Vertigo, Nausea, and Vomiting, without any headache.

Location of Pain

Throbbing pain usually occurs in one half of the head but can also be experienced at one point in head, in the forehead, or even in the whole head.

Duration of pain

And episode lasts only a few seconds or minutes. Only rarely they can persist for a couple of days, but not more than that.


The major symptom of Vestibular Migraine is a spontaneous episode of Vertigo. Other associated symptoms are:

  • Motion sickness associated with the movement of the head
  • Dizziness by looking at moving objects
  • Nausea and vomiting caused by constant dizziness.
  • Loss of balance
  • Tinnitus
  • The feeling of fullness in the ears
  • Partial or complete distortion of hearing

Migraine headache symptoms like:

  • A throbbing Headache
  • Photophobia and Phonophobia
  • Visual auras
  • Problems with vision


The exact cause is not completely understood. Some studies associate Vestibular Migraine with misfired nerve signals between neurons in the brain during a migraine attack. Release of excessive neurotransmitters is another possible cause.

Triggers of a Vestibular Migraine

There are no certain triggers but some factors that can trigger a migraine attack have also triggered an episode of Vestibular Migraine in most cases. Some of those triggers are:

  • Stress and anxiety
  • Weather changes
  • Changes in atmospheric pressure
  • Lack of sleep
  • Dehydration
  • Menstruation
  • Wine, aged cheese, preservatives, and MSG containing foods.

Risk Factors

Many studies suggest that vestibular migraine are more common in:

  • Females
  • Individuals who already suffer from Migraines
  • People with the family history of the condition
  • Individuals with Meniere’s syndrome.
  • People who suffer from Benign Paroxysmal Positional Vertigo (BPPV)


The diagnosis can only be made by taking a proper history of the onset, duration, and frequency of episodes and its associated symptoms. Since an episode of Vestibular Migraine can occur without any headache. Thus, this can make it difficult to reach a diagnosis and can be confused with Benign Paroxysmal Positional Vertigo or Meniere’s disease, based on the vestibular symptoms occurring alone. The general practitioner will refer the case to an ENT specialist to rule out any differential diagnosis.


Treatment for vestibular migraines is very much similar to the treatment for other migraines.

Conventional treatment:

  • Eating a healthy diet
  • Avoiding stress
  • Taking a good night’s sleep
  • Avoiding any food triggers
  • Regular exercise
  • Identification and avoidance of personal triggers
  • Lying down in a dark room and avoiding any sort of movement during an episode
  • Vestibular rehabilitation in case of severe cases or frequent episodes.

Medical treatment:

  • An over-the-counter analgesic for pain relief if the headache is present
  • Vestibular suppressant
  • Benzodiazepines for anxiety
  • Anti-emetics
  • Tricyclic antidepressants

When to consult a doctor?

If you’ve experienced at least five episodes of vestibular symptoms with or without any headache, that lasted from 5 minutes to 3 days and you have a history of migraines, you should book an appointment with a general physician. The GP would look into your symptoms and refer you to an ENT specialist or a Neurologist depending on the diagnosis.


Can change in my dietary habits help me treat vestibular migraine?

Yes, an episode of vestibular migraine can be triggered by certain foods, identifying and avoiding your triggers can help decrease the frequency of episodes you have been experiencing.

I do not have a headache but my vestibular symptoms are quite severe, what are the chances that I am suffering from vestibular migraine?

If you have a previous history of migraines and you have experienced a similar episode of vestibular symptoms with or without headache it is very likely that you are suffering from vestibular migraine. An episode of Vestibular Migraine can only consist of vestibular symptoms as well.

What steps can I take during an episode of vestibular migraine to decrease the severity of my symptoms?

Lie in a quiet dark room
Avoid any movement
Try to manage your stress
Hydrate yourself
If your doctor has suggested a vestibular suppressant you can take that.
For pain relief, you can take triptans, as per your doctor’s prescription.

Do I need any sort of long term treatment after relief from vestibular migraine?

Vestibular rehabilitation is often required to stabilize the vision and to restore the ability of eyes to track the movement.