Vestibular migraine episodes involve vertigo and can last anywhere from a few minutes to a few days. They can make you feel dizzy and lightheaded, especially when moving your head.

You might often associate migraine episodes with painful headaches, but they can include many other symptoms, too. Some migraine episodes do not even involve pain. The types of symptoms you experience and when you experience them may help doctors understand the type of migraine and guide treatment.

Episodes of vestibular migraine are characterized by vertigo — a sense that objects around them are moving when they’re actually not. “Vestibular” refers to the system in your inner ear and parts of your brain that control your body’s balance.

Vertigo may be a symptom of several types of migraine, such as basilar migraine. But in vestibular migraine, the episode may not involve a headache.

Vestibular migraine is one of the most common vestibular disorders in the United States, affecting about 1 in every 37Trusted Source people.

The main symptom of vestibular migraine is an episode of vertigo. It usually happens spontaneously. You may also experience the following symptoms:

  • feeling of imbalance
  • motion sickness while moving your head
  • dizziness by looking at moving objects, such as cars or people walking
  • lightheadedness
  • feeling like you’re rocking on a boat
  • nausea and vomiting

Vestibular migraine episodes can last between 5 minutes and 72 hours. In most cases, symptoms last for a few minutes to a few hours.

It’s common to feel tired for up to 3 days following a vestibular migraine episode.

Experts aren’t sure what causes vestibular migraine, but some believe that the release of certain chemicals in the brain play a role.

Some factors that trigger other kinds of migraine can also trigger a vestibular migraine, such asTrusted Source:

Certain foods and drinks can also trigger a vestibular migraine, including:

Vestibular migraine is much more common in females. Some studies estimate it to be five times more common in females than in males. It’s worth noting that there’s no substantial research on migraine in people who are transgender. Some studiesTrusted Source suggest that transgender women who take hormonal gender affirming care are more likely to have migraine.

Vestibular migraine typically develops in middle adulthood. Research suggests that people with vestibular migraine first experience migraine headaches at an average age of 28. They experience vertigo first at an average age of 49Trusted Source. It tends to start younger in females.

Vestibular migraine may also run in families. Scientists have identified specific genesTrusted Source linked to an increased risk of vestibular migraine. Some of the genes follow an autosomal dominant inheritance pattern.

Vestibular migraine in children

Vestibular migraine can affect you at any age. However, only if you have a history of migraine, you can receive a diagnosis of vestibular migraine.

If a child does not have a history of migraine, a doctor may diagnose them with benign paroxysmal vertigo, a related condition that’s a precursor to migraineTrusted Source in children. However, doctors may diagnose benign paroxysmal vertigo in children or adults.

Vestibular migraine can be challenging to diagnose because there are no clear tests to detect it. Vestibular (balance) testing usually isn’t helpfulTrusted Source, and results can often apply to other vestibular disorders.

Instead, a doctor will discuss your symptoms and history and consider factors laid out by guidelines in the International Classification of Headache Disorders.

To receive a diagnosis, you must have:

  • a history of migraine
  • at least five moderate or severe vertigo episodes lasting 5 minutes to 72 hours
  • at least half of those episodes involve one of the following:
    • sensitivity to light and sound
    • visual aura
    • headache with at least two defining qualities (one-sided, pulsating, intense, or worsened by routine physical activity)

There must also be no other condition that better explains your symptoms.

A doctor will want to rule out these other conditionsTrusted Source causing similar symptoms:

Vestibular migraine vs. basilar migraine

Migraine with brainstem aura (MBA), (formerly called “basilar migraine”) is another type of migraine that commonly features vertigo.

However, vertigo in MBA typically occurs as part of migraine aura, lasting 5 to 60 minutes. It often precedes a headache. Less than 10% of people with vestibular migraine meet the criteria for MBA.

Research is insufficient on how best to treat a vestibular migraine episode in progress.

Also, no standard recommendation on how to treat vestibular migraine is available. Research suggests the most effective treatment for vestibular migraine may not be the same as for other types of migraine.

For example, according to a 2023 reviewTrusted Source, triptans provide little to no relief in vertigo symptoms for people with vestibular migraine. Triptans also carry a risk of severe side effects, including gastrointestinal and cardiovascular effects.

Medications that doctors prescribe to treat vertigo may provide relief from vestibular migraine episodes. These drugs help treat dizziness, motion sickness, nausea and vomiting, and other symptoms. Options includeTrusted Source:

Conventional migraine medications that may help treat headache as part of acute vestibular migraine episodes includeTrusted Source:

Other treatments for vestibular migraine focus on preventing or reducing the number of episodes. Prevention strategies typically include a combination of:

  • medication
  • vestibular therapy
  • lifestyle and diet changes

Medications to prevent vestibular migraine episodes

If you frequently experience episodes, a doctor may prescribe the same medications that help prevent other types of migraine. Those drugs include:

It’s unclearTrusted Source whether CGRP antagonists like erenumab (Aimovig) may help prevent vestibular migraine, but research is ongoing.

Vestibular rehabilitation to prevent vestibular migraine

Vestibular rehabilitation is a type of physical therapy focusing on improving balance and reducing dizziness. With the help of a trained professional, participants perform exercises to work on their balance, coordination, and eye movement control.

Experts consider it a safe and effective preventive treatment for vestibular migraine.

A 2017 studyTrusted Source found that vestibular rehabilitation reduced the severity of headache pain in people with vestibular migraine. A 2021 studyTrusted Source found that it also reduced the frequency of vertigo and headache episodes.

Lifestyle and dietary changes to prevent vestibular migraine

You can reduce the chance of getting a migraine by avoiding foods and drinks that may trigger them. Pay attention to what you eat or drink. You may notice a pattern. Keeping a food diary can help identify a trigger that upsets your body and leads to an episode.

Lifestyle changes can also help, such as:

If menstruation is a cause of your migraine episodes, it may help to take a water pill and avoid eating salty foods.

There’s no cure for migraine. Migraine is a chronic (long-term) condition that you have throughout life. But in some people the frequency of their migraine decreases with ageTrusted Source.

However, according to the American Migraine Foundation, vestibular symptoms in migraine can at times increase with age.

A 2012 German studyTrusted Source followed people with vestibular migraine for almost 10 years. The frequency of vertigo lessened in 56% of cases, increased in 29%, and was about the same in 16%.

People with vestibular migraine may also be more likely to get motion sicknessTrusted Source and are at a greater risk of ischemic strokeTrusted Source. Talk with a doctor about treatment and prevention of these conditions and any other concerns you may have.

Vestibular migraine is one of the most common vestibular disorders. It may affect you if you have a history of migraine and episodes of vertigo that may or may not include a headache. Episodes typically last minutes to hours but could last as long as 3 days.

Medications that treat dizziness may help you during a vestibular migraine episode, as may some conventional migraine medications. Preventive treatments are also available. Knowing and avoiding your migraine triggers can go a long way in reducing the frequency of episodes.

Talk with a doctor if you have a history of migraine and regularly experience periods of dizziness or loss of balance. They can provide you with a diagnosis and a treatment plan to reduce symptoms and improve your quality of life.