It is important to take a thorough history. Patients may or may not have a history of concurrent migraine. Dizziness can occur during a headache-free interval, or many years after the last migraine. Dizziness symptoms include spontaneous rotational vertigo, positional symptoms, motion intolerance, and visual motor sensitivity.
These symptoms can occur for seconds, minutes, or hours, Dr. Cass said.
Vestibular testing is not diagnostic, he continued. Vestibular signs can be prominent during acute migraine but are less common in between headaches. Auditory symptoms such as hearing loss, tinnitus, and ear fullness are not uncommon but are rarely as prominent as vestibular symptoms, he said. Auditory symptoms tend to be bilateral and not progressive or fluctuating.