Oh it’s definitely NOT viral. That’s old fashioned BS. I also passionately believe the central only argument is mostly BS too but perhaps it’s at least half the story. In my view this condition is a combination of a varying level of inner ear issue plus significant neurological knock on effects. What is the inner ear issue? Almost certainly Hydrops as shown in that 2013 paper I shared. Hydrops can be asymptomatic wrt to hearing and varies in degree. So lack of auditory ear symptoms is no proof the ear is not involved.
I ABSOLUTELY have a migraine problem now because for example a chocolate brownie is guaranteed to cause me ‘migraine rumbles’ (but no migraine). This never happened before my ear injury. For all of my life I’ve been able to eat what I liked. So Dr. S is spot on with his diet. And to be honest his treatment plan is probably a very good place to start further research into why this diet helps. If you look at Alec Salts research on inner ear homeostasis you will notice that Potassium level likely affects endolymph volume (which is 75% potassium ions. Not very surprising really!!) And guess what? All of the restricted foods are high in potassium!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923478/#!po=51.8018
However my chocolate brownie affects me so very quickly it’s hard to believe it gets digested and processed through the blood and osmotic barriers so fast. I feel the effects within a minute or two. But there is no doubt it upsets my system.
The ‘final straw’ was when my current oto-neuro gave me a diagnosis of ‘Secondary Hydrops’ and informed me that sufferers of this condition find their symptoms worsen with ‘chocolate, some cheeses and red wine’!!! Implying that essentially SEH = MAV.
It also makes sense to me that it’s a lot easier to injure your ear than your brain which helps to explain the onset of MAV. You only need a perilymph leak from an inner window over a period of time to develop Hydrops in the ear. And the oval window is particularly vulnerable because it’s both incredibly thin and connected indirectly physically to outside world by the chain of little middle ear bones so transfer of pressure and force is fairly straightforward.
I would go further and hypothesise that it’s very possible many vanilla migraine sufferers have ear trouble. Or perhaps some have eye trouble. In any case probably root cause is bad sensory stability. Sensory instability has been written about as a likely cause of migraine.
I would definitely consider seeing Dr S even though we might disagree on hypothesis. My main reason for not seeing him would simply be that his protocol is in the public domain so I pretty much know what I should be doing to get better. That now goes for most doctors. This site has a lot to do with that.