Migraine Associated Vertigo (MAV) – Misdiagnosed as Meniere's

You're welcome.

James, From the Hopkins link I posted look in the left column at "Bilateral Loss of Labyrinthine Function". Select it. This article lists "Hereditary symptoms sometimes associated with migraine" as a potential cause.
http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/vestibular/conditions/bilateral_loss_of_labyrinthine_function.html

 

Could you please share the links to the journals/articles/websites you used for this posting?

 

Hi Folks,

Here's another very good article on migrainous vertigo that everyone here should read. It summarises the current knowledge very well and will aid anybody here in establishing a treatment strategy. One interesting point mentioned and one that is fitting for this thread is the following:

"Successful treatment depends on adherence to recommendations. A first obstacle may be patients accepting their diagnosis. This is difficult when diagnosis is based on symptoms and without an independent diagnostic standard. This problem applies to migraine in general, although the condition is well known, and even more so to vestibular migraine. As most vestibular episodes are temporarily independent of headache it often seems illogical for patients to link them with migraine."

The full PDF can be seen here for free:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105632/pdf/10.1177_1756285611401647.pdf

J

 

Hi SCC -- sorry for the delay. This information came from the following publication by Steven D Rauch:

http://www.ncbi.nlm.nih.gov/pubmed/20713240

J

 

larryking: great post, thanks for the information.

 

Went to my first appointment at the House Clinic. The doc agreed that my symptoms are leaning toward MAV and gave me an rx for Pamelor. The last neurologist said it would be improbable that I had both MM and MAV.
Just goes to show you that doing your own research and working with your doctor (that you see eye to eye with) pays off. Starting the Pamelor tonight. Have a balance test next at the clinic as soon as my insurance authorizes it.

 

I'm going to have to come back and read those articles when I have a little more time. Thanks for posting them. I have MM and Mav and Silent Migraine.

 

Butterfly!
Great to see you back on the board.I hope you are feeling better!

 

Here are some links to medical articles about the link between Migraine Disease and hearing loss.

Pubmed.gov is the United States National Library of Medicine National Institutes of Health website that maintains a repository of medical articles and journals written by doctors all over the world.

In my experience dealing with medical challenges that brought me to this site I have found that doctors rely on published research which has been generally accepted by their peers to form their opinions. Many of the ones I have worked with have been receptive to articles written by other doctors. Rarely have they had they been as receptive to on-line forum discussions. The receptive ones I still work with. The doctors who could not be open minded and think outside the box are no longer my doctors.

Below are a few published abstracts (brief synopsis of the full medical article) that might interest you. I typed “Migraine Hearing Loss” in the search box at PubMed to find these articles. To view the full articles you need to find a medical library in your area. Most can be found at or near your local teaching hospital. If you get yourself to one of these libraries you can view the articles for free and print copies for a nominal fee. Checking through the individual journals at the library can also bring up more documentation. The articles will always list the following items to aid you in finding them:

Name of the medical journal in which it was published including date, volume, issue and page number(s)
PMID (PubMed article identification number) or Medline ID number.
Author and location of where the author works.

Vestibular Migraine: perspectives of otology versus neurology
http://www.ncbi.nlm.nih.gov/pubmed/21178806

Otalgia associated with migraine (Ear Pain Associated with Migraine)
http://www.ncbi.nlm.nih.gov/pubmed/21178808

Migraine with transient unilateral hearing loss and tinnitus
http://www.ncbi.nlm.nih.gov/pubmed

Basilar artery migraine presenting as fluctuating hearing loss and vertigo. http://www.ncbi.nlm.nih.gov/pubmed/112535

Meniere’s Disease or Migraine? The clinical significance of fluctuating hearing loss with vertigo. http://www.ncbi.nlm.nih.gov/pubmed/112535

Neurotology of Migraine
http://www.ncbi.nlm.nih.gov/pubmed/9439080

 

I cannot read through all of these great posts. But I am on topamax. I went off of it when I was so sick but my migraines came back with a vengeance. I have tried diets and triggers but I still get migraines. I cannot take the pain. I have a very high pain threshold too. I know there are side effects to topamax, I wonder if there is a cleaner medicine that works? I was taking inderal but that stopped working.

 

Are you able to take Verapamil?

 

I don't know. I will ask my surgeon. I go next month for my tubes. My left ear drum has burst twice. I will ask then. Have you had success?

 

Yes. It worked quite well for me.
Read about it here:
http://www.menieres.org/forum/index.php/topic,24931.30.html

 

So cal cyclist, excuse my ignorance but i am just starting to research mav. is it possible to have mav and all of the four ingredients of menieres ie tinnitus/hearing loss/vertigo/fullness?
ie., would a menieres patient and a mav patient have the exact same set of symptoms?
interesting stuff..

 

Look back on the top of page 14 of this discussion and click on the link to Johns Hopkins. They do a very good job of describing MAV and Meniere's.

Personally I've had all the symptoms normally associated with MM with the exception of hours and hours of whirl and hurl vertigo. Instead I've experienced constant imbalance which is sometimes bad enough to cause me nausea and the inability to hold down what is in my stomach.

I believe the most telling difference between the two maladies is that MM is episodic in nature. You have the increase in symptoms, all hell breaks loose, the episode is over, you are pretty much normal in between episodes. MAV on the other hand can leave you in a state where you are constantly experiencing symptoms.

The only true way to figure out if you have MAV is by being prescribed migraine medications to see if they reduce or eliminate your symptoms. If they do then MAV/Migraine could be the root of your issues. If you have a family history of migraine the chances of your symptoms being caused by migraine increase.

There is not a test for MM. The only way to arrive at that diagnosis is through process of eliminating all other possible causes for your symptoms.

I recommend these books on migraine. Find them at your local library. They are easy reads and do a great job of educating without patronizing.

"Living Well With Migraine Disease and Headache" by Teri Robert (a migraineur and advocate)
"Heal Your Headache" by David Buccholz (a doctor who has studied migraine extensively)

For the record migraine is not a headache, nor is it just a horrible episode of head pain. Either of these books will explain the many different forms of migraine and their symptoms.

 

I am not going to wait until my appointment. I sent him an email asking to switch to verapamil.

 

He just wrote me and is phoning in a prescription for verapamil.

I will try it. This weather is not helping. I've been staving off one this morning.

 

So Cal has pretty much nailed it in answering your question. Yes, you can have the exact same symptom set - hence the difficulty in diagnosing either condition. To add to the confusion, you can have both - in fact people with MM seem to have migraine substantially more than the general population.

There can be subtle differences though. Periods of MAV (rather than 'a migraine') tend to be chronic - lasting weeks, months, or even years. Permanent hearing loss with MAV while possible, is fairly rare - it tends to return once the MAV has passed. The vertigo tends to be of the rocking type rather than spins.

If you respond to eliminating triggers and/or migraine meds then it's probably migraine. The confounding thing can be though that there are a lot of potential triggers and a lot of migraine meds. It may take a while to find what works for you.

The other thing to keep in mind is that while MM is quite rare (and often misdiagnosed) migraine is very common. Sadly MAV is still not widely recognised or understood so people may get a diagnosis of MM when in reality they have migraine.

No simple answers I'm afraid - hence the existence of forums like these where everyone is trying to tease out what exactly their issue is.

 

This article on migraine is really excellent. I mean really. Excellent.

Presentation by Dr Nicholas Silver to the UK Parliamentary Group on Headache Disorders.

http://www.ukfibromyalgia.com/conditions-mistaken-for-fm/migraine.html

 

Count me amongst the ones with MAV and permanent hearing loss. See my post on page 14 for links to medical articles connecting hearing loss to migraine.

Aladdin- I hope the script works for you. What was the dosage prescribed?