Vestibular migraine is a common central vestibular disorder with a heterogeneous clinical presentation and its diagnosis is based mainly on history,lacking specific biological markers.Using video-oculography,the character-istic positional nystagmus distinct from peripheral and other central disorders,can be observed during the ictal and inter-ictal phases of vestibular migraine.In this article,the pathogenesis,clinical presentation,diagnosis and differentials,and future perspectives of positional nystagmus in vestibular migraine are discussed to raising clinical awareness.