Diagnostically, one must determine whether the dizziness and headaches are independent or related to each other, and in particular, whether they are a manifestation of migraine. Here we will review the association between vertigo and migraine. There is a male-female distribution difference. The remainder experienced vertigo either just before or during the headache. The incidence of vertigo during the headache period was higher in patients with aura as opposed to in those without aura.
Motion sickness is a common migraine accompaniment.
Syncope can also accompany migraine, and this offers another entirely separate mechanism. Symptoms include true vertigo with or without nausea and vomiting, and motion intolerance. Hyperacusis is common in migraine, which may differentiate it from most ear disorders. When patients are examined acutely when vertiginous, there is usually minimal or no spontaneous nystagmus. This provides a differential feature from most peripheral vestibular syndromes.