No strict rules, but when giving medical advice please try to provide sources supporting your claims.

Diagnostic criteria:

The current gold standard is the International Classification of

Headache Disorders, 3rd edition (ICHD‑3), which defines

Vestibular Migraine in collaboration with the Bárány Society.

Here’s the official diagnostic criteria (ICHD‑3, 2018) — a patient must meet all of A–E:

A. At least five episodes fulfilling criteria C and D.

B. Current or past history of migraine with or without aura (per ICHD‑3 rules).

C. Vestibular symptoms of moderate or severe intensity lasting 5 minutes to 72 hours.

“Vestibular symptoms” here include:

Spontaneous vertigo (internal or external spinning)

Positional vertigo

Visually induced vertigo (triggered by complex or large moving visuals)

Head‑motion–induced vertigo or dizziness with nausea

D. At least half of episodes are associated with ≥1 migraine feature:

Headache with ≥2 of these: unilateral location, pulsating quality, moderate/severe intensity, aggravated by routine physical activity. (Note: many patients that rarely get headaches still appear to be diagnosed with this anyways as some providers just use aura criteria in place of headache it seems)

Photophobia and phonophobia

Visual aura

E. Not better accounted for by another vestibular disorder or ICHD‑3 diagnosis.

Extra notes:

Attacks shorter than 5 minutes or longer than 72 hours are atypical and should be diagnosed cautiously.

Vestibular testing (VNG, calorics, vHIT) may be normal between attacks; diagnosis is clinical, not dependent on a lab result.

The Bárány Society’s wording matches ICHD‑3 almost exactly, but they emphasize that co‑existence with other vestibular conditions (like BPPV or Ménière’s) is possible, and diagnosis hinges on whether the migraine pattern explains the majority of vertigo attacks.