Vestibular migraine without a headache is real, and the criteria say so.

Can you have vestibular migraine without a headache?

Yes. Vestibular migraine can happen with no headache at all, and the diagnostic criteria were written to allow it. They require vertigo or dizziness episodes plus at least one migraine feature in half of them. That feature can be light and sound sensitivity or a visual aura instead of head pain.

So if your attacks look like a spinning room, a floor that rocks or a store aisle that won't hold still, and your head feels fine through all of it, that still fits the diagnosis.

For some people the headaches came first, sometimes years earlier, and the dizziness showed up later. Bring that history to your appointment. A past migraine counts toward the diagnosis as much as what's happening now.

What the criteria actually require

The vestibular migraine criteria came out of a joint effort by the Bárány Society and the International Headache Society. They were published in 2012 and carried into ICHD-3, the classification neurologists use for headache disorders. They sit in the appendix as research criteria, separate from the main list of migraine types.

Read them closely and you won't find a headache requirement. You need at least five episodes of moderate or severe vestibular symptoms lasting 5 minutes to 72 hours. You need a current or past history of migraine. And in at least half of those episodes, one migraine feature has to show up: a migraine-type headache, light plus sound sensitivity, or visual aura. Then a clinician rules out other causes.

Compare that with migraine without aura, where the attack is defined by the headache.

Why headache-first trackers lose these attacks

Many migraine logs open with the same question: how bad is the pain? Score it, pick a location, save. That works for a headache. For a headache-free vestibular attack it quietly breaks the record, because a zero on the pain scale reads as a good day or never gets entered at all.

The people this fails worst are the ones whose symptoms don't arrive as neat episodes. One line from our audience research says it in five words: "I don't have attacks... constant." A tracker that waits for a headache before it opens an entry has nowhere to put that.

And the gap has a cost. The criteria ask how many episodes you've had, how long they lasted, and whether half carried a migraine feature. A log that only holds the painful days can't answer any of those questions at the appointment where they matter.

How to log a headache-free attack

Log the dizziness as the attack. Start the entry when the vertigo starts, even with zero pain, and capture the details a clinician will ask about. Each field below maps to a reason it matters.

Day-to-day dizziness needs its own note. If you're unsteady on most days for three months or more, ask about persistent postural-perceptual dizziness (PPPD). It can sit alongside vestibular migraine, and it has its own criteria and treatment approach.

Postdrome was built around a continuous symptom timeline instead of a headache-shaped entry. So a dizzy day with no pain still lands on the record, and so does the foggy, light-sensitive stretch after it. Your data stays on your phone and exports when your neurologist asks for it.

When dizziness needs urgent care

Vestibular migraine is diagnosed by pattern and by ruling out other causes. A first episode, or one that feels different from your usual, belongs with a clinician. For recurring episodes, a headache specialist or a neuro-otologist is the right next appointment, and two to three months of logs will make that visit far more useful than memory alone.

Some symptoms skip the appointment queue entirely.