A Narrative Review of Vestibular Migraine: Integrating Neurology and Otolaryngology Perspectives

Abstract

Vestibular migraine (VM) is a common but underrecognized cause of recurrent vertigo and dizziness at the interface of neurology and otolaryngology. This structured narrative review integrates both perspectives in VM diagnosis and management. A PubMed search was conducted on 13 May 2026 using keywords related to vestibular migraine, vertigo, dizziness, migraine, diagnostic criteria, otolaryngology, neurology, Ménière’s disease, vestibular rehabilitation, CGRP, treatment, and management; reference checking added one key consensus document, yielding 46 articles for synthesis. VM remains a clinical, criterion-based, and longitudinal diagnosis without a pathognomonic biomarker. Neurology emphasizes migraine features and central warning signs, whereas otolaryngology emphasizes vertigo phenomenology, auditory symptoms, audiovestibular testing, and differential diagnosis. Management is individualized and multimodal. Integrated neuro-otological reasoning may improve diagnostic accuracy and patient-centered care, but stronger VM-specific trials with standardized vestibular outcomes are needed.