Hi Thank you for asking HCM. I have gone through your query. Migraine can be accompanied by nausea vomiting and black outs. But it will improve when you recover from the attack. A consultation with neurologist and imaging of brain should be carried out to rule out any organic problems with brain. Other causes like sinus or ear problems should be ruled out also. If all these clear then it can be treated as migraine. Prophylactic medications like propranolol or topiramate daily will be helpful to abort the attacks if you getting it frequently. Anti emetics like ondansetron and analgesics like ibuprofen will be helpful during attacks also. Hope this may help you. Let me know if anything not clear. Thanks.