Conditions
Vestibular migraine is migraine that shows up as dizziness or vertigo, sometimes with little or no head pain. That is one reason it can be hard to recognize. This page covers what it is, how it is defined by medical experts, and how we look at it at Strong Tower.
Dizziness or vertigo together with a sudden, severe headache, double vision, numbness, weakness, or confusion should be treated as an emergency. Mayo Clinic lists headache with double vision, numbness or weakness, confusion, or seizures as reasons to seek emergency care (Mayo Clinic, July 2025). Call 911 or go to the nearest emergency department.
The vestibular system is the network of inner ear sensors, brainstem, cerebellum, and brain areas that helps keep you balanced and your vision steady. People with vestibular migraine can find that head movement, busy visual environments, or position changes trigger dizziness, vertigo, or a floating, unsteady feeling.
Diagnostic criteria were published in 2012 by the Bárány Society and the International Headache Society (Lempert et al., Journal of Vestibular Research, 2012). In short, they call for recurrent vestibular symptoms of moderate or severe intensity, episodes lasting from 5 minutes to 72 hours, a current or past history of migraine, and a link in timing between the vestibular and migraine symptoms. Other causes of the symptoms need to be ruled out.
Because the diagnosis depends on ruling out other causes, it is made by a medical provider. A functional neurology evaluation can add information about how your balance, eye movements, and neck are working, but it does not replace that diagnosis.
Symptoms can include:
Spinning (vertigo) or rocking sensations lasting minutes to days
Dizziness or unsteadiness set off by head movement or busy visual scenes
Motion sensitivity, including car sickness or discomfort when scrolling on a screen
A floating or off-balance feeling
Brain fog, trouble concentrating, or fatigue during episodes
Headache, light sensitivity, or sound sensitivity, though these are not always present
Possible contributors include past concussion or whiplash, hormonal changes, poor sleep, and high stress. Some people also over-rely on vision for balance after a vestibular problem, which can make busy visual settings harder. We look at how your eyes, inner ears, and neck work together.
Mayo Clinic's list of general migraine triggers, such as hormonal changes, stress, sleep changes, and skipped meals, may also apply.
Dr. Wright is a Doctor of Chiropractic with advanced training in functional neurology. We look at how your eyes, inner ears, neck, and balance are working together, as described on our Neurological Exam & Evaluation page. Exercise-based care for the balance system is described on our Vestibular Rehabilitation page.
Our care is meant to be complementary to your medical care.
Migraine & Headache: the main page on migraine and other headache types.
Vertigo & Balance: dizziness, tinnitus, and balance problems in general.
PPPD: chronic non-spinning dizziness that can overlap with vestibular migraine.
BPPV: short spells of spinning set off by head position.
Yes. The published criteria require a history of migraine, but the dizziness episodes do not have to come with head pain.
The criteria describe episodes from 5 minutes to 72 hours.
BPPV causes brief spells of spinning, usually under a minute, set off by changes in head position. Vestibular migraine episodes last longer and may come with migraine features. The two can be confused, so a clinician's evaluation matters.
A medical provider makes the diagnosis after ruling out other causes. Many people see a primary care doctor, a neurologist, or an ear, nose, and throat doctor.
Whether care here is a fit depends on your situation, which we look at in your evaluation. We see our care as complementary to your medical care.
See our Migraine Specialist in Smyrna, GA, Marietta, Atlanta, Sandy Springs, and Roswell pages.
Next steps
If dizziness keeps coming back, we would be glad to take a closer look.