DOI: 10.31067/acusaglik.1993494 ISSN: 1309-470X

Rehabilitation in Vestibular Migraine: A Narrative Review of Clinical Features, Pathophysiological Basis, and Personalized Approaches

Ceren Bayrak Dörtkol, Ozan Dörtkol
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Purpose: Vestibular migraine (VM) is one of the most common causes of episodic vertigo, characterized by recurrent attacks of vertigo and/or dizziness accompanied by migrainous features. However, its diagnosis is frequently delayed. In addition to headache, complaints such as motion sensitivity, visual dependence, balance impairment, and interictal dizziness may restrict activities of daily living. Because pharmacological treatments do not fully eliminate these symptoms, vestibular rehabilitation has gained prominence. This review aimed to evaluate the clinical and pathophysiological features of VM from a rehabilitation perspective.Methods: Studies published between January 2016 and May 2026 in the PubMed, Web of Science, and Google Scholar databases were screened, and 28 studies were included and synthesized narratively.Results: Mechanisms such as vestibulo-trigeminal interaction, central sensitization, multisensory integration dysfunction, and visual dependence were linked to rehabilitation targets. Although current studies support that vestibular rehabilitation may have beneficial effects on dizziness-related disability, balance, gait performance, and quality of life, the methodological heterogeneity of these studies limits the generalizability of the findings.Conclusion: Vestibular migraine should be regarded as a sensory processing disorder arising from the central interaction of visual, vestibular, somatosensory, and trigeminal networks, and rehabilitation should be personalized according to the patient’s symptom phenotype, trigger profile, and functional goals. Technology-assisted systems appear promising as a complement to structured, physiotherapist-supervised programs; in the future, phenotype-based randomized controlled trials incorporating objective outcome measures and long-term follow-up are needed.

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