Vertigo as a symptom of migraine – article

[scott]

Hi All,

A new paper from Germany.

The pathogenesis of VM is uncertain, but migraine mechanisms may interfere with the vestibular system at the labyrinth, brainstem, and cerebral cortex. Treatment includes vestibular suppressants for acute attacks and migraine prophylaxis for patients with frequent recurrences. However, treatment efficacy has not been validated by properly controlled clinical trials. VM does not fit into the 2004 International Headache Society Classification ...



http://www.glycemicindex.com/sd/vertigo_symptom_migraine09.pdf

Scott

[MAVLisa]

thanks for the article, Scott. how are you?

[scott]

Hi Lisa,

Thanks for asking. I'm really not doing very well at all. I haven't come close to returning to baseline now for about 2 weeks. The gastro bug has left me trashed as has the trip home. Since being back at work I've been running around like crazy and then yesterday had to drive 250 km on the highway. That was the last straw because the whole time I had to chat to someone and concentrate on the road. When I arrived at the group I was monitoring, the whole room was moving and I felt very uneasy. It settled down after some valium and food but then I drove home feeling very tired then woke today feeling really bad. Stoned, surreal and dizzy feeling. On the Mac now and it's rough. I'll likely go home soon. This is too much to handle. I just took Ativan as well.

I can hardly complain though because I know you are really suffering over there Lisa with the pregnancy. How much more time before the baby is born and you can get stuck into some Zoloft? It must be getting close now. Does valium help at all or is that a no-no while being pregnant? Probably not good to have in your system I imagine.

This condition really is the pits. I'm amazed at how it can suddenly tirn into something so ugly overnight.

Hope you are having a good evening.

Best ... Scott

[georgekoch]

In accordance with most published reports, the proposed criteria conceptualize VM as an episodic vestibular disorder.

Oh really? I thought the whole problem with MAV'ers is that they're often misdiagnosed as having some kind of a vestibular disorder, like labs or VN. Haven't we here at MVert unofficially "established" that MAV can AFFECT the vestibular system but doesn't ORIGINATE there? Secondly, why "episodic"? What about those of us (like MAVLisa and me) who have it constantly, not in attacks?

The first diagnostic step is distinguishing between vertigo (a vestibular symptom) and nonvestibular dizziness. This distinction can usually be made by a careful history: a sense of rotation or other illusory sensations of motion indicate vertigo; whereas sensations of lightheadedness, dizziness, or impending faint imply nonvestibular dizziness.

First they called MAV "a vestibular disorder" and now they're confusing the issue by talking about what's vestibular and what isn't. (So when they say "nonvestibular dizziness" above, does that mean "migrainous dizziness" or the opposite?)

But more to the point, Isn't this overgeneralizing? Don't we have "definite" MAV'ers here whose dizziness IS (or HAS BECOME) more than just abstract dizziness? MAVLisa gradually had her MAV turn into more of a rocking sensation (or at least that rocking was added to the existing symptoms). Bottom-line question to the authors: "When dizziness/MAV progresses from one distinct form to another, then what? How do you classify dizziness that changes appearance?"