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Vestibular Migraines: Headaches With Nausea and Dizziness

Medically reviewed by Jezreel Esguerra, MD · General Practitioner

Written by Lorraine Bunag, R.N. · Updated Mar 12, 2023

    Vestibular Migraines: Headaches With Nausea and Dizziness

    If you repeatedly face nausea and dizziness along with headaches, you may be experiencing what doctors refer to as vestibular migraine. Here’s what you need to know about this type of headache. 

    Vestibular Migraine Is A Little Strange, Even For Doctors

    The term “vestibular” refers to the inner ear and sense of balance. When you have vestibular migraine (also known as migraine-associated vertigo), it means you have vestibular symptoms, such as nausea and dizziness, along with your headache. 

    But what makes migraine-associated vertigo a little strange is the fact that vestibular symptoms may occur even without the migraine pain. 

    Sometimes, too, vestibular symptoms take place after the attack or they resemble the aura (sensory disturbances) migraineurs experience before or during the migraine headache. 

    Due to these complexities, doctors usually look into 5 to 8 years of the patient’s history of headaches and dizziness for diagnosis. After all, vestibular symptoms are also associated with a wide range of illnesses. 

    Signs and Symptoms to Watch Out For

    With or without a headache, vestibular migraines mirror many of the signs and symptoms of classic migraines, which include:

    • Moderate to severe headache, usually on one side of the head. Pain can be throbbing or pulsating. 
    • Nausea and vomiting
    • Auras or sensory disturbances before or during an attack
    • Sensitivity to light, smell, and noise

    The vestibular symptoms to watch out for are:

    • Sensitivity to motion
    • Feeling unsteady 
    • Loss of balance
    • Dizziness, lasting for minutes to hours but can persist for days. 

    Vestibular migraine symptoms, including nausea and dizziness, may last for a few minutes to a few days. According to doctors, an attack can be debilitating even in the absence of a headache. 

    Red Flags That It’s Not Vestibular Migraine

    Since vestibular migraine symptoms, such as nausea and dizziness, are not enough to arrive at a diagnosis, one should at least know about the red flags that the vertigo is not associated with migraine. Some of these red flags are:

    • Sudden loss of hearing – this may indicate an infection that needs prompt treatment. 
    • Loss of balance occurring alone or with weakness – may point to stroke, especially for people with high cardiovascular risk. 
    • Progressive or intermittent hearing loss – particularly when accompanied by ear fullness and ringing or buzzing in the ears may indicate Meniere’s Disease. 

    Understanding these red flags is crucial because they need immediate treatment. In the case of Meniere’s disease, complications, such as permanent hearing loss, may occur when the condition is left unchecked. 

    How to Treat Vestibular Migraines

    If you experience headaches along with nausea and dizziness and are suspecting vestibular migraine, know that it usually responds to standard migraine care and prevention. 

    Treatment usually involves:

    Eliminating the triggers

    Do you suspect that your vestibular migraine occurred due to some triggers? If so, eliminate those triggers and do your best to avoid them in the future. 

    Common triggers include changes in eating or sleeping habits, stress, and some foods. 

    Considering supplements

    They will not give you relief, but doctors say supplements, such as riboflavin and magnesium, might help. 

    Taking some medications

    Some prescription medicines also work for migraine-related vertigo, but if you don’t respond to them, you might want to ask your doctor for prescription drugs. 

    Reports say anti-vertigo and antiemetic (for vomiting) medicines are useful in suppressing vestibular symptoms. Some antihistamines are also helpful in the treatment of mild vertigo and motion sickness. 

    For frequent attacks, the doctor may recommend one or a combination of the following:

    • Calcium channel blockers
    • Beta-blockers
    • Topiramate 
    • Serotonin or serotonin/norepinephrine reuptake inhibitors (SSRIs or SNRIs)
    • Tricyclic antidepressants

    Key Takeaways

    Do you experience headaches accompanied by nausea and dizziness? If so, you might be experiencing a vestibular migraine. Most cases of migraine-related vertigo respond to classic migraine prevention and treatment. If your case does not get better with the standard treatment, please seek professional medical advice.

    Learn more about Headaches and Migraines here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Jezreel Esguerra, MD

    General Practitioner

    Written by Lorraine Bunag, R.N. · Updated Mar 12, 2023

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