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

Amazon.com has very reasonably priced used copies of the Heal Your Headache book. I got mine for around $5.00 and it is in perfect shape.

I personally feel the lines are blurred alittle bit between MM and Migraines as after having a horrendous vertigo attack years ago I never really recovered and was from that point on having balance issues everyday and had the feeling I was going to fall over alot. I never suffered from migraines until I had my vns surgery. It touches base in the Heal Your Headache book in a small paragraph about migraines after a cranial surgery.

But as we all know we are differant. So I am only speaking for myself.

Burd has helped me a lot with migraine questions as I have odd symptoms such as bloodshot eyes that show up on days were the pressure in my head is extreme. Burd found a link for me stating this is indeed a migraine symptom. Thanks for all of your help Burd :-*

 

Hi Butterfly. You are welcome.

Holly, vertigo is a false sense of being in motion, or the world around us moving when it really isn't. It can spin, it can pitch up and down, it can fling around at random. Regardless of what causes it, vertigo is what it is. Sometimes it gets confused with dizziness, which is an unsteadiness, a loss of balance, and that can me a mild aggravation or it can be debilitating where one can't even walk and anything in between. Bad dizziness can make you throw up, and, migraine can also cause drop attacks too.

 

I believe diagnoses of MM and migraine are so difficult because there is a great deal of overlap in symptoms which apply to other conditions. Frustratingly many of the symptoms are in that 'vague' and subjectively felt areas such as dizziness, vertigo, sensory perception and so on. As Burd pointed out - migraine is often misdiagnosed as the following:

Add to that virus, auto immune disorders, labrynthitis, vestibular neuritis, MS and many more.

It is very very frustrating, not just to us but I would imagine also to the doctors.

The majority of society, which includes the medical profession, think of migraine as being crippling headaches. To be fair, for 90% of migraine sufferers that is the case. But that still leaves a hell of a lot of people who experience a huge range of symptoms, which are all migraine related but which either don't include headache at all, or it's part of a 'suite' of symptoms. I think, the lack of headache as a symptom probably means a lot of doctors don't even consider migraine as a possibility.

 

Thanks burd, the problem I have is that the vertigo that you describe is the type of vertigo I've experienced. BUT - everyone that I've read says you can't have vertigo without the puking, crawling, can't get out of bed or even move vertigo. I also get dizzy but there are many times that I have a sense of gravitational pull or the room is rocking but I haven't had the extreme reactions that people with true vertigo have. In otherwords, I don't know where I fit in all this descriptive mess.

 

Just that in itself feels points to a migraine issue and not a mm issue. Meniere's is much more consistent than migraine. Migraine fluctuates continually and even the same person can have greatly varying reactions. I have had different degrees of vertigo and different degrees of dizziness. I have thrown up and I have not thrown up. But the constant is this...vertigo made me or the room appear to be in motion. Dizziness made me feel off balance and unsteady, has distorted my reality of what is level and what isn't, and made me very oversensitive to motion but I had no sense of motion beyond what was reality even though it was distorted or exaggerrated. They both have fluctuated but within their definitions they were what they were. Clear as mud?

 

I received some excellent information from Scott from an article about migraine triggers.

"An Analysis Of Migraine Triggers In a Clinic-Based Population"
by Diane Andress Rothrock MS, Wesley King, MD, John Rothrock, MD,
2010 American Headache Society

Here's a link to the full article.
http://www.mvertigo.org/articles/migraine_triggers2010.pdf

This new article from Headache about migraine triggers makes for an interesting read. They evaluated 200 new migraine patients referred to their clinic. Not surprisingly stress came out on the top of the pile and was consistent with previous work done where 1200 migraineurs were surveyed. But also note that poor sleeping patterns (as noted by Dr Nicholas Silver) and various odors (as I so often speak of from personal experience about fragrances, chemicals, and outgassing) were also very high on the list.

Conclusions
A large majority of migraineurs report migraine attack triggers, and the triggers most commonly reported include emotional stress, a disrupted sleep pattern, and various odours. These findings do not appear to vary according to geographic region or race/ethnicity. Among the triggers, menstrual migraine appears inclined to provoke headache that is more severe, less amenable to treatment, or longer in duration than headaches that occur at other times during the cycle.

Thank you Scott for sending this article my way. May this information be helpful to others in their search to get well.

 

And MM...I have severely limited my diet...I do not even eat meat anymore! and I love a good rare piece of beef on Saturday night! but so far my limitations have been keeping the beast at bay. I could just be in remission...who knows? When the hydrops sets in I am afraid to eat or expose myself to anything! It is truely maddening.

 

Pretty much! Relocate to a bubble now and adopt a Breatharian diet.

 

Hi Holly, just wanted to let you know that I have had really awful vertigo attacks and none of them have involved the hugging the toilet, puking for hours that some here have experienced. In fact although I get extreme nausea with my attacks it has never led to vomiting.

It is my belief that the puking vertigo is more consistent with Meniere's than MAV.

 

My brother, who I don't see very often, has been aware of my dietary limitations but didn't know about the inhaled offenders. We were together ordering lattes and when I got done requesting the alterations and substitutes, he says "So why don't you just order a cup of air with some air or can't you have that". I said "well actually I really can't have much of that either". LOL

 

I think they call that drink a 'why bother' or at least that is what they call the diet decaf stuff I drink

 

That's a good one too June

Hey burd, you said something about I might have MAV due to some of the symptoms I was talking about - I was also diagnosed with AIED. My immune system is destroying the cells of my inner ear. The diagnoses came with the bi-lateral MM. Also, I've never in the fifteen years I've had this disease found a trigger which, most of the MAV people talk about. Do you really think it's worth going through all the tests to find out? I know it's up to me but, would it make a difference in how I was treated for it?

 

Holly, if anything physical has been ruled out, like tumors and such, I wouldn't do any extra testing. You are talking about tests recommended by a doctor right? It is never a bad idea to test yourself about possible triggers though, to see if something is aggravating your symptoms. And that you do on your own with all the advice in the recommended books and from the forum. It is a good idea to research medications you are on. At the least I would chart everything I ate, including drinks, condiments, medications, everything, for a few months, times of day for it all, symptoms and the times of day for that, to see if any patterns emerge. Also note anything that affects air quality, when you are exposed to anything obvious like dust from a deep cleaning project, vacuuming, animal exposure, smoke or mold exposure, chemicals, gas fumes from fueling the car, etc etc. At the same time pull any obvious fragrances out of your house. It would be awesome if you could knock vertigo/dizziness practically out of your life.

 

Thanks burd - that's a tall order but I'll see if I can handle it.

The only real thing I know right now is it always, I mean always gets worse throughout the day. It's like I wake up and I feel better (the monster is there but not in my face screaming and my brain fogging it up) and as the day goes through and I stay awake, it gets worse and worse until I go to bed. Sometimes when it gets really bad, I will go in to take a nap to try to keep it at bay.

 

This may help some with trying to identify what is triggering their migraine activity.
I haven't used it but it was recommended by a friend as a possible help to some. It's worth checking into...
http://mymigrainejournal.com/

(they use the term headache in place of migraine symptoms but it would apply to all manifestations of migraine activity)

 

bump for RevJim

 

Wow, thanks Burd, this trigger diary is great. You're the best!

 

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



http://www.mvertigo.org/articles/MAV_MM_case_reports_2010.pdf

"Recent reports have focused on a possible association between migraine and Menière’s disease; patients suffering from Menière’s disease
present a higher rate of migraine. In some cases, the clinical features of migraine-associated vertigo may mimic the presentation of
Menière’s disease."

Thank you Scott, for sharing this article.  May it help to further educate others and increase awareness of a possible migraine connection with their mm symptoms, to check into all their options and not blindly accept being labeled as having menieres. May all continue researching and learning.

 

From the article mentioned above...

Patient #1
• 42-year-old female, suffering from migraine with aura according to IHS criteria. The final diagnosis was made by a senior neurologist. The patient reported the first attack of migraine at the age of 20 years, which more typically occurred before menstruation, at a frequency of 1-2/month. Her family history was positive for migraine (mother and one of three sisters).
• patient reported recurrent episodes of rotational vertigo (about 1/month) lasting from a few minutes to 1-2 hours, often with a right ear fluctuating hearing loss. Migraine and vertigo never occurred together.
• She also reported the presence of tinnitus which increased before vertigo attacks.
• Caloric tests demonstrated a right sided unilateral weakness (26%) during caloric stimulation according to Freyss and the Head Impulse Test was positive on the horizontal plane with refixation saccades towards the left side.

Patient #2
• 59-year-old female with a long history of migraine which began at the age of 23 and ceased at the age of 50, immediately after onset of menopause.
• Over the last year, she reported various episodes of rotational vertigo normally lasting for 2-3 hours with hearing loss on the left side. She reported increased hearing loss during vertigo. Audiometric examinations demonstrated a low frequency sensorineural hearing loss.
• Preventive therapy of md with betahistine 24 mg twice a day, salt restriction and increased water intake did not prevent vertigo attacks, which remained unchanged in frequency and duration in a 6-month follow-up.

Drug prophylaxis of migraine with Topamax 100 mg a day and aspirin (100 mg a day) produced a clear decrease in vertigo attacks, in both patients, in a 1-year follow-up.