Key points
- Migraine is a complex neurological disorder, not simply a bad headache.
- Attacks can include nausea or vomiting and sensitivity to light and sound, and some people experience aura with temporary visual, sensory or speech and language symptoms.
- Dizziness or vertigo can be prominent in some people. Vestibular migraine is a recognised condition, but dizziness has many possible causes, so its presence alone does not confirm it.
- New, sudden or distinctly unusual neurological symptoms should not simply be assumed to be migraine, and warrant appropriate medical assessment.
More than a bad headache
Migraine is a complex neurological disorder characterised by recurrent attacks that can include headache alongside a range of other symptoms. International diagnostic criteria recognise nausea or vomiting and sensitivity to light and sound as common features of migraine without aura.
Aura and symptoms before the headache
Some people also experience aura, which can involve temporary visual, sensory or speech and language symptoms. Migraine may have symptoms before the headache phase as well. These can include fatigue, difficulty concentrating, neck stiffness, sensitivity to light or sound, nausea and yawning. Aura can occasionally occur without a subsequent headache.
When dizziness is part of the picture
Dizziness or vertigo can also be prominent in some people. Vestibular migraine is a recognised condition in which repeated episodes of vestibular symptoms occur in association with a history of migraine and other migraine features. Importantly, dizziness has many possible causes, so its presence alone does not mean someone has vestibular migraine.
When to seek medical assessment
Because migraine symptoms can overlap with other neurological conditions, new, sudden or distinctly unusual neurological symptoms should not simply be assumed to be migraine and warrant appropriate medical assessment.
Discuss your symptoms with us
If headaches, migraine symptoms or recurrent dizziness are affecting your day-to-day activities, an assessment may help clarify your presentation and whether physiotherapy has an appropriate role. Book a consultation with our clinic to discuss your symptoms.
Key evidence
- Ferrari, M. D., Goadsby, P. J., Burstein, R., Kurth, T., Ayata, C., Charles, A., Ashina, M., van den Maagdenberg, A. M. J. M., & Dodick, D. W. (2022). Migraine. Nature Reviews Disease Primers, 8, Article 2. DOI: 10.1038/s41572-021-00328-4.
Comprehensive contemporary review describing migraine as a chronic disorder involving recurrent disabling attacks and accompanying neurological symptoms, including aura. - Headache Classification Committee of the International Headache Society. (2018). The International Classification of Headache Disorders, 3rd edition (ICHD-3). Cephalalgia, 38, 1–211. DOI: 10.1177/0333102417738202.
International diagnostic standard. Migraine without aura criteria recognise nausea and vomiting and photophobia and phonophobia; migraine with aura criteria define transient neurological symptoms and recognise that aura may sometimes occur without headache. - International Headache Society and Bárány Society. ICHD-3 Appendix: Vestibular migraine.
Defines vestibular migraine using recurrent vestibular symptoms, migraine history and associated migrainous features, and makes clear that the diagnosis must not be better explained by another vestibular disorder.
This article is general information and is not a substitute for individual assessment, diagnosis or advice from a qualified health professional. A diagnosis of concussion must be obtained from a medical practitioner. If you are concerned about a medical emergency, call emergency services straight away. To discuss your own situation, get in touch or book a consultation.
