Vestibular migraine: Diagnostic criteria
Open accessAbstract
This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). It contains a literature update while the original criteria from 2012 were left unchanged. The classification defines vestibular migraine and probable vestibular migraine. Vestibular migraine was included in the appendix of the third edition of the International Classification of Headache Disorders (ICHD-3, 2013 and 2018) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included in a later version of the ICHD, when further evidence has accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms. Symptoms that qualify for a diagnosis of vestibular migraine include various types of vertigo as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window of between 5 minutes and 72 hours.
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Episodic disorders add distinctive vestibular symptoms to the background of PPPD.
“Episodic disorders add distinctive vestibular symptoms to the background of PPPD [58], such acute attacks of vertigo plus cephalalgia, photophobia and phonophobia, with or without visual aura for vestibular migraine [49], short-lived positional vertigo for BPPV [87], or attacks of vertigo, tinnitus, and fluctuating hearing for Menière’s disease [51].”
PPPD may be preceded by episodic vestibular disorders such as vestibular migraine, Menière's disease, and BPPV that cause distinct bouts of vestibular symptoms.
“PPPD may be preceded by episodic vestibular disorders such as vestibular migraine [49], Menière’s disease [51], and BPPV [87] that cause distinct bouts of vestibular symptoms in contrast to the persistent, waxing and waning dizziness, unsteadiness and non-spinning vertigo that are hallmarks of PPPD.”
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Self-citation
- Authors
- Lempert, T., Olesen, J., Furman, J., Waterston, J., Seemungal, B., Carey, J., Bisdorff, A., Versino, M., Evers, S., & Newman-Toker, D.
- Affiliations
- Schlosspark-Klinik (DE)
- University of Copenhagen (DK)
- University of Pittsburgh (US)
- The Alfred Hospital (AU)
- Charing Cross Hospital (GB)
- Johns Hopkins University (US)
- Department of Neurology, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg
- University of Pavia (IT)
- University of Münster (DE)
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Corresponding author
- Lempert, Thomas
- ORCID
- Venue
- Journal of Vestibular Research
- Publisher
- SAGE Publications
- Published
- 2012-11-01
- Volume
- 22
- Issue
- 4
- Pages
- 167-172
- ISSN
- 0957-4271 (ISSN-L)
- 1878-6464
- PMC
- PMC9249276
- OpenAlex
- W1490160136
- Cited by
- 1,109
- References
- 23
- Citations by year
- 2026: 78 · 2025: 100 · 2024: 84 · 2023: 124 · 2022: 116 · 2021: 121 · 2020: 112 · 2019: 85 · 2018: 61 · 2017: 57 · 2016: 50 · 2015: 52 · 2014: 36 · 2013: 32
- FWCI
- 26.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Vestibular Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Academy of Medical Sciences (AMS-CSF3-Seemungal)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- vestibular migraine, diagnostic criteria, vertigo, nausea, migraine, vestibular symptoms, ICHD-3, International Headache Society
- MeSH terms
- Dizziness, Humans, Migraine Disorders, Vertigo, Vestibular Diseases
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