OT: Migraine-associated vertigo

Well, I got the results of the CT scan, the MRI, and fistula test, and the VEMP on Tuesday from the ENT: The CT seems to clearly establisth that there is nothing going on with my inner ear except maybe a slight right-sided weakness in the vestibular system of unknown origin (picked up in the VNG) in spite of the weird test results on the audiogram, tympanometry test including middle ear reflexes, the VNG, a VEMP test, and a fistula test. And since the MRI showed a "mild chronic microvascular ischemic gliosis in the periventricular and subcortical white matter bilaterally" the ENT sent me off to visit with a neurologist, who just happened to have a cancelation today.

The neurologist's take on the MRI is that it's normal age-related stuff.

The neurologist's take on the vertigo is that it's likely being caused by two things. One component is most likely migraine related. Now I've had migraines since my 20s, so it makes some sense. Particularly since both flashing lights and loud noises can trigger the vertigo (or a migraine in me). But previous to these vertigo spells getting worse the last 6 months, my migraines have always been very mild---I can often ignore them or take an ibuprophen or at worst lie down in the dark for an hour or so, and the headache is then quite managable. [I have friends and relatives with moderate and severe migraines---so I know how lucky I've been with my very mild ones.]

But the vertigo is beginning to interfere with daily life---feeling dizzy has lead to a couple of falls and several other near falls, as well as it's pretty disorienting to suddenly feel like you just stepped off a Tilt-a-Whirl. And because of this, the neurologist has prescribed Topomax to try to prevent the migraines that are showing up as dizzy spells with or without an accompanying headache. I have to be patient with this approach since it will take several weeks before the Topomax will become effective. *sigh*

There may also be a second component that may be something going on with a weakness on the right side of the vestibular system indicated by the VNG test. So there's one more test---a so-called "rotary chair" test---that he wants done. It's scheduled on Tuesday, the same day I get to pick up the new PR S1 BiPAP Auto.

So over the Christmas break, I will likely not be around on this board as much as I have since I think it's now time to start also haunting the migraine boards in search of anything I might be able to do to manage that problem too. But I do intend to continue browsing and posting here too.

Robysue, I don't know if this will help you, but I suffer from migraines that last for about three days at a time. They are miserable. In conjunction with those, I have lightheadedness and some dizziness, not to the extent you describe though. I started taking Singulair for allergic rhinitis and it actually has helped with the lightheadedness and occasional dizziness. After researching Singulair, I found out is has been used as an off-label drug for migraine prevention. You might give it a try, if you don't already take it. In terms of the Topamax, I did try that some years ago but couldn't handle the side-effects (tingling in the extremeties). We will miss you on the board. I hope you get well soon!

There is something called Autogenics which both I and my sister used to prevent and handle migraines.

It is a relaxation technique - for migraines the important part is to into and out of trans many times a day. It changes your circulation, improves it. I will try to get you more links after work. It is used by NASA for anti motion sickness training

I also am having trouble with vertigo but no migraines. The ENT tells me it is crystals (they have a name like ooliths, or something like that) swimming around in the wrong canals in my inner ear. I have had 2 procedures he reccommended to get them re-aligned but am still having problems. He is kinda at a loss as to why this hasn't worked. Any ideas from anybody??

kentoboo wrote:I also am having trouble with vertigo but no migraines. The ENT tells me it is crystals (they have a name like ooliths, or something like that) swimming around in the wrong canals in my inner ear. I have had 2 procedures he reccommended to get them re-aligned but am still having problems. He is kinda at a loss as to why this hasn't worked. Any ideas from anybody??

kentoboo,

The crystals you're talking about are what causes BPPV (Benign Paroxysmal Positional Vertigo). The procedures you've had are most likely the Semont and/or Epley maneuvers, and they are supposed to be highly effective against BPPV, but they may need to be done more than once.

I was tested for BPPV and that test came up quite conclusive: I do NOT have BPPV. *sigh* That was a diagnosis that I had sort of hoped I'd get because BPPV is "fixable" in a rather straightforward fashion. But it also didn't surprise me that the test for BPPV turned up negative since the main triggers for vertigo in BPPV are not really problems for me AND the main causes of my vertigo are not causes of vertigo for BPPV sufferers.

As to why the BPPV maneuvers aren't working for you: Have you had a test called a VNG or an ENG? And did the part of that test that's designed to catch BPPV show that you actually have BPPV? Because my guess is that if the diagnosis was made on just your description of the problem and you haven't had a VNG or ENG yet, maybe you don't actually have BPPV. Maybe there's something else that is causing the problem. But if you have had a VNG, it's possible that you simply need to have the Semont and/or Epley maneuvers repeated several times to get some stubborn otoconia (aka "ear rocks") to move back where they belong and out of the semicircular canals where they currently are. A decent webpage for some basic information about BPPV is http://www.tchain.com/otoneurology/diso ... /bppv.html

Good luck.

Oh, you'll just love the "rotary chair"...it's like sitting in a washing machine and see who can throw up first!! I also went through the whole vesticbular clinic stuff for vertigo. I would just be going along and suddenly it felt as if the world just tilted and then I'd feel dizzy. They finally diagnosed "migraine without headache" or "aural migraine" and gave me a script for Ativan. If "the world tilts" I take 1/2 and that will stop it. It it comes on totally, usually I'm in bed when it happens. Feels like a really, really bad hangover! Sick to my stomach and so dizzy I have to crawl to the bathroom. But no headache. Then I take a whole pill and go back to bed for about 8 hours until it clears.

I also get "optical migraines" which start with seeing swirling, flashing lights, kaleidescope. 1/2 pill takes care of this one too. If I don't have meds, it'll last about 30 minutes to an hour. Not good for driving, but doesn't interfere with life as much. I have a friend with optical migraine who thought she'd had a stroke because she lost vision in one eye and ended in ER.

Good luck with the chair and the new meds.

robysue, I have had the tests and they did confirm BBVP. I guess I will just have to have more procedures to try and get those rascals back in place. Thanks for your post.

monica4patience wrote: I also get "optical migraines" which start with seeing swirling, flashing lights, kaleidescope. 1/2 pill takes care of this one too. If I don't have meds, it'll last about 30 minutes to an hour. Not good for driving, but doesn't interfere with life as much. I have a friend with optical migraine who thought she'd had a stroke because she lost vision in one eye and ended in ER.

Good luck with the chair and the new meds.

My mom was first diagnosed with optical migraines back in the 70s after about 3 months of tests to rule out every other possible thing that could have been going on in her brain including brain cancer and stoke. She had really bad visual symptoms, but NO HEADACHE would ever follow them. The vision problems would last for about 30 minutes to a couple of hours.

Me, well I was first diagnosed with migraines back in the 80s when I was in my mid 20s. Most of the time, I just get a mild migraine headache with no aura. But the headaches are triggered by all kinds of classic migraine triggers including lights, sounds, and smells. Sometimes I do get auras though. But I've never been on meds before because the migraines have always been mild in pain even when they've been frequent. Most of the time, I can simply lie down in the dark and quiet for about 30 minutes to take the edge off (without needing to take anything at all). And a lot of the time I can simply ignore the pain because it's not too bad. But the vertigo I can't seem to ignore: Once the world starts to spin, I start tripping over my feet for the rest of the day and bumping into things. And the clumsiness continues after the world stops spinning and I'm back down to my normal "background" dizziness and lightheadness that I've had as far back as I can remember.

Thanks for sending the good luck wishes my way.

robysue, bless your heart! I've had migraines for years, but have only rarely had any vertigo with them. Wish I could tell you something that would help with the vertigo. I did find out years ago what has really been the most effective way to control my migraines. I take two lose-dose aspirin every morning, and have one cup of green tea. This simple therapy has taken me from having 3 or 4 migraines a week (some of which lasted for more than 6 hours) to about 3 or 4 a year (none of which last more than a couple of hours.) I still have to be careful about my diet--red wine and I are no longer friends--and try to stay away from flashing or too-bright lights, but the aspirin & green tea have changed my life. Might not work for everybody, but it's easy & cheap to try! I wish you luck in finding out how to solve this problem.