Headache and vertigo are both very common symptoms, and the three most common symptoms encountered in a person’s life are fever, headache, and vertigo. One disease that combines these two symptoms is migrainous vertigo. This disease is relatively new and has many names, such as migraine-related vertigo, vestibular migraine, and benign recurrent vertigo. It should be noted that although it is called migrainous vertigo, it is possible that half of the patients do not have accompanying headache, or they used to have headache but now they do not. Yu Shudong, Department of Otorhinolaryngology, Shandong Qianfo Mountain Hospital Migrainous vertigo is a common clinical disease, and its incidence is the second highest among all vertigo diseases. The reason why migrainous vertigo is so easily misdiagnosed is that the symptoms of migrainous vertigo are varied. First of all, the onset of vertigo in migrainous vertigo varies widely, from a few minutes to a few hours, or even up to a day, and in some severe cases, the vertigo continues for several days. Secondly, the symptoms accompanying vertigo are also varied. Many patients with vertigo have symptoms such as photophobia and phonophobia, but not all patients have these symptoms. Some patients also have positional vertigo, and others have symptoms such as ear congestion and hearing loss, so it can easily be misdiagnosed as Meniere’s disease. We have found that many patients with migrainous vertigo are diagnosed with Ménière’s disease. It is important to note that some people think that Ménière’s disease and migrainous vertigo are intertwined, but we feel that the two diseases can be distinguished with careful differentiation. The onset of Ménière’s disease is characterized by tinnitus and a rise in the ears, and the onset of the above-mentioned symptoms is markedly aggravated or appears, with hearing loss in one ear or abnormalities in its vestibular function. Migrainous vertigo, on the other hand, either has no hearing impairment or presents with bilateral symmetrical hearing impairment and is accompanied by photophobia and phonophobia symptoms. Also, migrainous vertigo mostly has motion sickness, which means that it is mostly motion sickness. In contrast, Meniere’s disease mostly has no motion sickness. It is important to point out that migrainous vertigo can cause some other diseases, such as positional vertigo and sudden deafness, and we need to differentiate them from the original diseases. Another way to differentiate migraine vertigo from other diseases is that migraine vertigo has an effect on migraine preventive medication, while other diseases do not. Migrainous vertigo also needs to be distinguished from some central system disorders, which are often accompanied by other signs of cranial nerve damage, but not migrainous vertigo. How is migrainous vertigo treated? Generally speaking, migrainous vertigo can be treated according to the stepwise treatment method. For patients with short and infrequent attacks, the disease can be prevented by avoiding the factors that trigger migraine vertigo attacks in life. For patients with recurrent vertigo attacks, it is necessary to apply drugs to prevent attacks. There are many drugs to prevent migrainous vertigo attacks, such as cipro, verapamil, propranolol, venlafaxine, topiramate and a large number of other drugs, which need to be evaluated and selected according to the patient’s condition. It is also important to pay attention to vestibular rehabilitation exercises in the treatment. With proper treatment, migraine vertigo is still very treatable.