Is it possible to have migraine associated vertigo without a headache?


It is possible for someone to have migraine-associated vertigo without a headache. Headache is just one symptom of migraine and not everyone has headache as a symptom of their migraine.


“It [migraine-associated vertigo without a headache] usually implies a diagnosis that's been coined as vestibular migraine. For a long time now, when patients come to see me, they fill out a questionnaire, and on that questionnaire are a number of different symptoms that they may experience. On that questionnaire, I have dizziness and lightheadedness, and over the past 20 years, it's amazing how many patients will tick that box that they had dizziness, or lightheadedness either with their attacks and sometimes apart from their attacks.

“So now we're starting to recognize the fact — not just neurologists, but ENT doctors who see a lot of patients with dizziness — that in young women in particular who have recurrent vertigo, migraine is the most likely diagnosis.

“And you're right, like many symptoms of migraine, they can occur alone or in combination with other symptoms. As you know, you don't even need to have a headache to have migraine. I tell patients it's like a wheel with multiple spokes, and each spoke is a symptom. Sometimes you'll have one spoke. Sometimes you'll have five spokes. Sometimes you'll have all the spokes on the wheel. You can get dizziness, or vertigo associated with a typical migraine attack, which accompanies a headache, and sometimes not. It can occur in isolation or it can occur in conjunction with other migraine symptoms, like sensitivity to light and noise, and nausea. So absolutely we see a lot of dizziness and vertigo in our migraine population.”

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David Dodick, MD

Professor (Emeritus)
Mayo Clinic, Arizona

David Dodick, M.D., FAAN, is a professor of neurology at the Mayo Clinic College of Medicine and Science in Scottsdale, Arizona. He is the director of the headache program and the sports neurology and concussion program at Mayo Clinic in Arizona. He is an adjunct professor in the department of neurosciences, Norwegian University of Science and Technology. Dr. Dodick is board certified by the Royal College of Physicians and Surgeons of Canada and the American Board of Psychiatry and Neurology (ABPN). He also holds United Council for Neurologic Subspecialties certification in headache medicine and ABPN certification in vascular neurology.

Dr. Dodick has authored more than 380 peer-reviewed publications and authored/edited 10 books. He is the chair of the American Migraine Foundation, chair of the American Academy of Neurology (AAN) Annual Program Concussion Committee, co-director of the American Registry of Migraine Research, chair of the International Registry for Migraine Research, chair of the International Headache Society Global Patient Advocacy Coalition, co-director of the Annual AAN Sports Concussion Conference, president-elect of the International Concussion Society, immediate past-president of the International Headache Society, former editor-in-chief of Cephalalgia, and past-president of the American Headache Society.