What tests are used to diagnose a vestibular migraine?
There is no single test to diagnose a vestibular migraine. At Children’s Hospital Colorado, we’ve created the Pediatric Balance and Vestibular Disorders Clinic to help diagnose and treat conditions like vestibular migraines.
Our neurologists and audiologists work together for comprehensive neurologic and vestibular testing to rule out other causes of dizziness. Your child may also be evaluated by an otolaryngologist (ear, nose and throat doctor, or ENT), and we may recommend imaging tests.
It’s helpful to keep a journal of your child’s episodes including time and length of episodes, symptoms, and events that may have triggered an episode. These details can help us make a diagnosis.
We follow diagnostic criteria formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The criteria to diagnose vestibular migraines are:
- At least 5 episodes with vestibular symptoms of moderate or severe intensity, lasting 5 minutes to 72 hours
- Current or previous history of migraine with or without aura (sensory disturbances) according to the International Classification of Headache Disorders (ICHD)
- At least 50% of vestibular episodes have one or more migraine features
- Headache with at least two of the following characteristics:
- One-sided location, pulsating quality
- Moderate or severe pain intensity, aggravation by routine physical activity
- Photophobia and phonophobia
- Visual aura
- Not better accounted for by another vestibular or ICHD diagnosis
What can I expect from vestibular migraine workup?
The first step is a vestibular evaluation, which may require a referral to Audiology Services from your child’s doctor. This evaluation varies depending on your child’s age and developmental level and will be scheduled for either 1.5 hours or 2.5 hours.
Depending on the evaluation results, your child may be referred to the Pediatric Balance and Vestibular Disorders Clinic for a multidisciplinary exam by doctors from Otolaryngology (ENT), Audiology, Physical Therapy and Neurology. If your child already has a managing neurologist, we may refer you back to that provider for vestibular migraine diagnosis and treatment instead of the balance and vestibular clinic.