What Do Vestibular Tests Reveal in Vestibular Migraine?

Vestibular migraine (VM) causes recurrent vertigo but lacks specific diagnostic tests. This study examined three tests: videonystagmography (VNG), caloric testing, and video head impulse test (vHIT). Researchers analyzed data from 193 VM patients diagnosed between January 2016 and May 2026. All patients underwent these tests on the same day, outside acute attacks. Results showed that 66.3% of patients had normal vHIT results, while 33.7% had abnormalities. The average vestibulo-ocular reflex (VOR) gain was 0.97 overall, but 0.86 in those with abnormal vHIT. Oculomotor issues were found in 38.3% of patients, positional test positivity in 20.7%, and caloric test abnormalities in 27.4%. The study highlights the variability of test results in VM patients, suggesting that a combination of tests may improve diagnosis and understanding of this condition. Clinical relevance: This research indicates that multiple vestibular tests may enhance diagnosis of vestibular migraine.