Headache Hub guide
Vestibular migraine: symptoms, criteria, and tracking
Episodes of vertigo, dizziness, and balance problems in people with a migraine history. This guide explains what vestibular migraine feels like, the international diagnostic criteria behind it, and how tracking your own pattern changes the conversation with your doctor.
- ICHD-3 code A1.6.6
- About 1% of the population
- Episodes last 5 minutes to 72 hours
The condition
What is vestibular migraine?
Vestibular migraine is a neurological condition characterized by episodic vertigo or dizziness in people with a current or past history of migraine. It is the most common cause of episodic vertigo in adults and sits at the intersection of migraine and vestibular disorders.
Key characteristics
- Episodic vertigo or dizziness with a current or past migraine history
- May occur with or without concurrent headache
- Episodes typically last 5 minutes to 72 hours
- Often set off by typical migraine triggers
Prevalence and demographics
- Prevalence
- About 1% of the population
- Gender ratio
- 5:1 female to male
- Peak age
- 40 to 50 years
- Migraine history
- About 90% have one
Impact on daily life
Vestibular migraine can significantly affect quality of life, including work, driving, and daily activities. Recognition by a clinician enables targeted treatment and symptom management.
The clinical standard
International classification criteria
Specialists diagnose vestibular migraine using criteria from the ICHD-3 appendix (code A1.6.6), developed jointly with the Barany Society. All five must be met.
Criterion A
At least 5 episodes
Vestibular symptoms of moderate to severe intensity.
Criterion B
Migraine history
A current or previous history of migraine according to ICHD-3.
Criterion C
Migraine features (at least 1)
During at least 50% of episodes: headache, photophobia, or phonophobia.
Criterion D
Duration
Episodes last 5 minutes to 72 hours.
Criterion E
Not better explained
Not attributed to another vestibular disorder or ICHD-3 diagnosis.
How tracking helps with the criteria
Every criterion above depends on details that are easy to lose between visits: how many episodes, how long they lasted, and which migraine features came with them.
Patterns over time
Ember records your dizziness and vertigo episodes alongside your migraine history, so the pattern becomes visible instead of staying scattered across months of memory.
The full picture
Balance symptoms, triggers, and migraine features like light and sound sensitivity are captured together, the same details the ICHD-3 criteria ask about.
A history your clinician can use
Your diary becomes a structured summary that helps your physician distinguish vestibular migraine from other vestibular and headache disorders.
Vestibular migraine often goes unrecognized. A structured symptom history helps your clinician see the pattern. Ember helps you track and organize; it does not diagnose.
Symptoms
Types of vestibular symptoms
Vestibular migraine episodes can take several forms, and many people experience more than one.
Rotational vertigo
A spinning sensation, as if the room is rotating around you.
Positional vertigo
Dizziness triggered by head movements or changes in position.
Visually induced dizziness
Dizziness triggered by visual motion or busy patterns.
Head motion intolerance
Discomfort with head movements during everyday activities.
Common triggers
The same triggers that set off migraine attacks often set off vestibular episodes. Tracking yours is the first step to managing them.
Lifestyle
- Stress and anxiety
- Sleep deprivation
- Hormonal changes
- Certain foods
Environmental
- Bright or flickering lights
- Weather changes
- Strong odors
- Loud noises
Physical
- Rapid head movements
- Car or air travel
- Visual motion, such as scrolling
- Physical exertion
Questions
Frequently asked questions
Keep reading
Related migraine and balance conditions
Next step
Dizziness and headaches, tracked together
Describe your episodes in your own words. Ember organizes them into a history you and your doctor can act on.