Vestibular Migraine Diagnostic Criteria and Characteristics

Diagnostic Criteria

The Barany Society diagnostic criteria require at least 5 episodes of vestibular symptoms of moderate to severe intensity, with a duration ranging from 5 minutes to 72 hours, and a current or previous history of migraine with or without aura according to the International Classification of Headache Disorders, with one or more migraine features during at least 50% of vestibular episodes 1, 2, 3
The diagnostic criteria also require the exclusion of other vestibular disorders, and the presence of headache with at least two characteristics: one-sided location, pulsating quality, moderate/severe intensity, aggravation by physical activity, photophobia, phonophobia, or visual aura 1, 2, 3

The lifetime prevalence of vestibular migraine is 3.2% in the general population, and it accounts for approximately 14% of all vertigo cases 4, 5

Vestibular symptoms in vestibular migraine may include spontaneous vertigo, with episodes lasting from minutes to several days, and may be accompanied by headache or other migrainous symptoms 2, 3, 6
The severity of vestibular symptoms is rated as "moderate" when they interfere with but do not prohibit daily activities, and "severe" if daily activities cannot be continued 2, 3

Vestibular migraine must be distinguished from other vestibular disorders, including benign paroxysmal positional vertigo (BPPV), Ménière's disease, brainstem and cerebellar stroke, transient ischemic attacks, intracranial tumors, and multiple sclerosis 4, 5, 6, 7