In short
Vestibular migraine is a common cause of recurring vertigo. Episodes of dizziness, motion sensitivity and imbalance are linked to migraine, with or without a headache. Care combines medical migraine management with vestibular rehabilitation.
Reviewed by Dr. Manan Patel, PT, DPT, TPS. Updated October 17, 2026.
Common symptoms
- Episodes of vertigo lasting minutes to days
- Sensitivity to motion, scrolling screens or busy store aisles
- Headache or light and sound sensitivity, though not always
- Lingering imbalance or a foggy feeling between episodes
Not sure this matches? Take the 60-second dizziness self-check.
What causes vestibular migraine?
The exact cause is not fully understood. It is linked to how the brain processes sensory signals during migraine. Common triggers include poor sleep, stress, skipped meals, dehydration, hormonal changes and certain foods.
Vestibular migraine often overlaps with persistent postural-perceptual dizziness (PPPD), and migraine is common in people with Mal de Débarquement syndrome. Telling these apart shapes the treatment plan.
Neck pain and headaches, too?
Neck pain and stiffness are common in people with migraine and can make symptoms worse. Treating the neck is often part of the plan.
How we test
Your first visit is a full 60-minute, 1-on-1 evaluation, and treatment often starts the same day. Depending on your symptoms, testing can include:
- A detailed history, screened against published diagnostic criteria and coordinated with your physician
- Oculomotor and positional testing to rule out other causes such as BPPV
- Balance and visual-motion sensitivity testing
Understanding Vestibular Migraines
Vestibular Migraine (VM) is a central nervous system sensory-processing disorder. Unlike classic migraines, you do not need to have a throbbing headache during an episode—VM frequently manifests as episodes of spontaneous or positional vertigo, rocking unsteadiness, severe motion sickness, light/sound sensitivity, and visual motion intolerance.
Why Standard PT Gyms Trigger Vestibular Migraines
Because the migraine brain has a lowered sensory threshold and heightened cortical excitability, aggressive generic balance exercises in a noisy, brightly lit gym can overwhelm your nervous system and trigger an attack. Our quiet, 60-minute 1-on-1 clinical environment allows us to pace your habituation below your symptom-flare threshold.
Our Calibrated Vestibular Migraine Approach
- Paced Central Habituation TracksStep-by-step movement and head-turn exposures carefully titrated to expand your motion tolerance without provoking autonomic overload.
- Optokinetic & Visual Motion DesensitizationControlled exposure to scrolling patterns and visual flow to reduce dizziness in grocery stores, traffic, and on digital screens.
- Upper Cervical & Autonomic RegulationManual therapy to release trigeminocervical tension in the upper neck paired with autonomic pacing strategies.
Ready to Reclaim Your Balance & Confidence?
Looking for relief? Schedule a 60-minute 1-on-1 evaluation at our Alpharetta Clinic (Inside GBSPT) or our Cumming Clinic, or call (470) 380-7007.
Your treatment plan
Coordinate care
We work alongside your neurologist or primary care doctor, who manages migraine medication and triggers.
Habituation
Graded exposure to the motion and visual triggers that bother you, at a pace you can tolerate, reduces sensitivity over time.
Balance and confidence
Balance training and pacing strategies to get you back to work, driving and exercise.
Recovery and what to expect
Improvement is usually gradual, over weeks to months, and works best alongside medical migraine management.
Tips for daily life
- Keep regular sleep and meal times
- Track triggers in a simple symptom diary
- Stay well hydrated
- Take regular screen breaks and limit fast scrolling during flare-ups
When to get urgent care
Questions about vestibular migraine
Can I have vestibular migraine without headaches?
Yes. Many people have dizziness episodes with little or no headache.
Do I need a neurologist?
Diagnosis and medication are managed by a physician. We focus on reducing motion sensitivity and improving balance.
Related guides
- Vertigo, dizziness or lightheadedness? How to tell the differenceWhat spinning, rocking, woozy and faint usually mean, and when dizziness is an emergency.4 min read · Patients
- Concussion recovery: why complete rest isn't the answerWhy brief rest and gradual activity beat a dark room, and when to get rehab.3 min read · Patients
Browse all guides in our learning center
Related conditions
- Persistent dizziness (PPPD)A constant sense of rocking or swaying that does not settle.
- Mal de Débarquement (MdDS)A lingering rocking or bobbing sensation, often after travel.
- Concussion & post-concussion syndromeHeadaches, dizziness, fog and visual strain after a head injury.
- Vestibular rehabilitationHow testing and treatment work for every type of dizziness.
References
- Lempert T, et al. Vestibular migraine: Diagnostic criteria (Update). Journal of Vestibular Research. 2022.
Where to get treated
Book at either clinic. Same phone number, same team, same 60-minute visits.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
Also serving Johns Creek, Milton, Roswell, Suwanee and nearby communities.
