Vestibular migraine (VM) is a common episodic vestibular disorder characterized by a high misdiagnosis rate. It substantially impairs patients’ health-related quality of life and imposes considerable medical and socioeconomic burdens. In recent years, significant advances have been achieved globally and in China in the diagnosis and management of VM, laying a solid foundation for promoting standardized outpatient care and establishing a medical quality control evaluation system. Against this background, the Chinese Expert Collaboration Group for Medical Quality Control of Vestibular Migraine fully drew on international and domestic research evidence, closely integrated the current situation and clinical practice of dizziness and headache management in China, and strictly followed the Delphi procedure. The initial draft was formulated through systematic literature retrieval, and multiple rounds of anonymous questionnaires were conducted to extensively solicit opinions from national and regional experts, with continuous revisions until consensus was reached. The expert panel comprehensively reviewed relevant literature and guidelines worldwide, combined with expert interviews and multiple group discussions. After repeated demonstration and refinement, the panel finally established a complete set of 13 outpatient medical quality control indicators covering the whole clinical pathway of VM, including initial consultation, diagnosis, comorbidity evaluation, treatment and follow-up, among which 8 are assessment indicators and 5 are reference indicators. The present expert consensus embraces these indicators as a standardized tool to systematically promote the standardization and quality improvement of clinical practice for vestibular migraine.
| Published in | International Journal of Pain Research (Volume 2, Issue 3) |
| DOI | 10.11648/j.ijpr.20260203.12 |
| Page(s) | 82-93 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2026. Published by Science Publishing Group |
Vestibular Migraine, Medical Quality Control Indicator, Expert Consensus
VM | Vestibular Migraine |
ICHD-3 | International Classification of Headache Disorders, 3rd edition |
PPPD | Persistent Postural-Perceptual Dizziness |
DHI | Dizziness Handicap Inventory |
VADL | Vestibular Activities of Daily Living |
PHQ-9 | Patient Health Questionnaire-9 |
GAD-7 | Generalized Anxiety Disorder-7 |
PSQI | Pittsburgh Sleep Quality Index |
Item | Question | Yes | Sometimes | No | Score |
|---|---|---|---|---|---|
P1 | Does looking up increase your dizziness or unsteadiness? | □ | □ | □ | |
E2 | Because of your dizziness or unsteadiness, do you feel frustrated? | □ | □ | □ | |
F3 | Because of your dizziness or unsteadiness, do you restrict your travel for business or recreation? | □ | □ | □ | |
P4 | Does walking down the aisle of a supermarket increase your dizziness or unsteadiness? | □ | □ | □ | |
F5 | Because of your dizziness or unsteadiness, do you have difficulty getting into or out of bed? | □ | □ | □ | |
F6 | Because of your dizziness or unsteadiness, do you restrict your participation in social activities, such as going out to dinner, going to the movies, dancing, or attending parties? | □ | □ | □ | |
F7 | Because of your dizziness or unsteadiness, do you have difficulty reading? | □ | □ | □ | |
P8 | Does performing more ambitious activities, such as sports, dancing, or household chores, increase your dizziness or unsteadiness? | □ | □ | □ | |
E9 | Because of your dizziness or unsteadiness, are you afraid to leave home without someone accompanying you? | □ | □ | □ | |
E10 | Because of your dizziness or unsteadiness, have you felt embarrassed in front of others? | □ | □ | □ | |
P11 | Do quick movements of your head increase your dizziness or unsteadiness? | □ | □ | □ | |
F12 | Because of your dizziness or unsteadiness, do you avoid heights? | □ | □ | □ | |
P13 | Does turning over in bed increase your dizziness or unsteadiness? | □ | □ | □ | |
F14 | Because of your dizziness or unsteadiness, is it difficult for you to do strenuous housework or physical work? | □ | □ | □ | |
E15 | Because of your dizziness or unsteadiness, are you afraid that people may think you are intoxicated? | □ | □ | □ | |
F16 | Because of your dizziness or unsteadiness, is it difficult for you to go for a walk by yourself? | □ | □ | □ | |
P17 | Does walking down a sidewalk increase your dizziness or unsteadiness? | □ | □ | □ | |
E18 | Because of your dizziness or unsteadiness, is it difficult for you to concentrate? | □ | □ | □ | |
F19 | Because of your dizziness or unsteadiness, is it difficult for you to walk around your home in the dark? | □ | □ | □ | |
E20 | Because of your dizziness or unsteadiness, are you afraid to stay home alone? | □ | □ | □ | |
E21 | Because of your dizziness or unsteadiness, do you feel disabled? | □ | □ | □ | |
E22 | Because of your dizziness or unsteadiness, has stress been placed on your relationships with family members or friends? | □ | □ | □ | |
E23 | Because of your dizziness or unsteadiness, do you feel depressed? | □ | □ | □ | |
F24 | Has your dizziness or unsteadiness interfered with your job or household responsibilities? | □ | □ | □ | |
P25 | Does bending over increase your dizziness or unsteadiness? | □ | □ | □ | |
Total DHI: ______ / 100 | Physical (DHI-P): ______ / 28 | ||||
Emotional (DHI-E): ______ / 36 | Functional (DHI-F): ______ / 36 | ||||
1 | Independent; no difficulty or change in performance. | 7 | Must use special equipment or an assistive device designed for the task. |
2 | Uncomfortable, but no change in ability or quality of performance. | 8 | Requires physical assistance from another person. |
3 | Reduced ability or quality of performance, but the method of performing the task is unchanged. | 9 | Dependent on another person to complete the task. |
4 | Performs the task more slowly, cautiously, or carefully, or modifies the method of performing it. | 10 | Unable to perform the task because of dizziness or balance problems. |
5 | Prefers to use an ordinary object in the environment for support, but does not depend on it. | NA | Not applicable: the task is not usually performed, or the respondent prefers not to answer. |
6 | Must use an ordinary object in the environment for support. |
Task | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | NA |
|---|---|---|---|---|---|---|---|---|---|---|---|
F-1 Moving from lying down to sitting up | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-2 Standing up from a bed or chair | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-3 Dressing the upper body (e.g., shirt, bra, undershirt) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-4 Dressing the lower body (e.g., trousers, skirt, underwear) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-5 Putting on socks or stockings | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-6 Putting on shoes | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-7 Getting into and out of a bathtub or shower | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-8 Bathing in a bathtub or shower | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-9 Reaching for an item above your head (e.g., in a cupboard or on a shelf) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-10 Reaching for an item low down (e.g., on the floor or a lower shelf) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-11 Preparing a meal | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
F-12 Intimate activity (e.g., foreplay or sexual activity) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-13 Walking on a level surface | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-14 Walking on an uneven surface | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-15 Walking up stairs | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-16 Walking down stairs | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-17 Walking in narrow spaces (e.g., hallways or supermarket aisles) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-18 Walking in open spaces | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-19 Walking in a crowd | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-20 Riding in an elevator | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
A-21 Using an escalator | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-22 Driving a car | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-23 Carrying items while walking (e.g., a package or bag of rubbish) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-24 Performing light household tasks (e.g., dusting, putting items away, or clearing a table) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-25 Performing heavy household tasks (e.g., vacuuming or moving furniture) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-26 Participating in active recreation (e.g., exercise, morning activities, or walking a dog) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-27 Fulfilling an occupational role (e.g., working, caring for children, or studying) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
I-28 Traveling between places in the community (e.g., by car or bus) | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ | □ |
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APA Style
Kaiming, L., Sulin, Z., Hebo, W., Jianhua, Z. (2026). Expert Collaboration Group of Medical Quality Control in Vestibular Migraine. International Journal of Pain Research, 2(3), 82-93. https://doi.org/10.11648/j.ijpr.20260203.12
ACS Style
Kaiming, L.; Sulin, Z.; Hebo, W.; Jianhua, Z. Expert Collaboration Group of Medical Quality Control in Vestibular Migraine. . 2026, 2(3), 82-93. doi: 10.11648/j.ijpr.20260203.12
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Download@article{10.11648/j.ijpr.20260203.12,
author = {Liu Kaiming and Zhang Sulin and Wang Hebo and Zhuang Jianhua},
title = {Expert Collaboration Group of Medical Quality Control in Vestibular Migraine},
journal = {International Journal of Pain Research},
volume = {2},
number = {3},
pages = {82-93},
doi = {10.11648/j.ijpr.20260203.12},
url = {https://doi.org/10.11648/j.ijpr.20260203.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijpr.20260203.12},
abstract = {Vestibular migraine (VM) is a common episodic vestibular disorder characterized by a high misdiagnosis rate. It substantially impairs patients’ health-related quality of life and imposes considerable medical and socioeconomic burdens. In recent years, significant advances have been achieved globally and in China in the diagnosis and management of VM, laying a solid foundation for promoting standardized outpatient care and establishing a medical quality control evaluation system. Against this background, the Chinese Expert Collaboration Group for Medical Quality Control of Vestibular Migraine fully drew on international and domestic research evidence, closely integrated the current situation and clinical practice of dizziness and headache management in China, and strictly followed the Delphi procedure. The initial draft was formulated through systematic literature retrieval, and multiple rounds of anonymous questionnaires were conducted to extensively solicit opinions from national and regional experts, with continuous revisions until consensus was reached. The expert panel comprehensively reviewed relevant literature and guidelines worldwide, combined with expert interviews and multiple group discussions. After repeated demonstration and refinement, the panel finally established a complete set of 13 outpatient medical quality control indicators covering the whole clinical pathway of VM, including initial consultation, diagnosis, comorbidity evaluation, treatment and follow-up, among which 8 are assessment indicators and 5 are reference indicators. The present expert consensus embraces these indicators as a standardized tool to systematically promote the standardization and quality improvement of clinical practice for vestibular migraine.},
year = {2026}
}
TY - JOUR T1 - Expert Collaboration Group of Medical Quality Control in Vestibular Migraine AU - Liu Kaiming AU - Zhang Sulin AU - Wang Hebo AU - Zhuang Jianhua Y1 - 2026/07/28 PY - 2026 N1 - https://doi.org/10.11648/j.ijpr.20260203.12 DO - 10.11648/j.ijpr.20260203.12 T2 - International Journal of Pain Research JF - International Journal of Pain Research JO - International Journal of Pain Research SP - 82 EP - 93 PB - Science Publishing Group SN - 3070-1562 UR - https://doi.org/10.11648/j.ijpr.20260203.12 AB - Vestibular migraine (VM) is a common episodic vestibular disorder characterized by a high misdiagnosis rate. It substantially impairs patients’ health-related quality of life and imposes considerable medical and socioeconomic burdens. In recent years, significant advances have been achieved globally and in China in the diagnosis and management of VM, laying a solid foundation for promoting standardized outpatient care and establishing a medical quality control evaluation system. Against this background, the Chinese Expert Collaboration Group for Medical Quality Control of Vestibular Migraine fully drew on international and domestic research evidence, closely integrated the current situation and clinical practice of dizziness and headache management in China, and strictly followed the Delphi procedure. The initial draft was formulated through systematic literature retrieval, and multiple rounds of anonymous questionnaires were conducted to extensively solicit opinions from national and regional experts, with continuous revisions until consensus was reached. The expert panel comprehensively reviewed relevant literature and guidelines worldwide, combined with expert interviews and multiple group discussions. After repeated demonstration and refinement, the panel finally established a complete set of 13 outpatient medical quality control indicators covering the whole clinical pathway of VM, including initial consultation, diagnosis, comorbidity evaluation, treatment and follow-up, among which 8 are assessment indicators and 5 are reference indicators. The present expert consensus embraces these indicators as a standardized tool to systematically promote the standardization and quality improvement of clinical practice for vestibular migraine. VL - 2 IS - 3 ER -
Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, China
Department of Otolaryngology-Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, China
Department of Neurology, Hebei General Hospital, Shijiazhuang City, China
Department of Neurology, The affiliated Changzheng Hospital, Naval Medical University Chinese People's Liberation Army, Shanghai City, China
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