I found a few older threads on this but they were pretty outdated and I couldnāt gather much info. Has anyone experienced any relief from 24/7 Mav symptoms with the acute/abortive treatments? Iām trialing preventatives but while I wait months for those to work, wanted to see if I could get any relief in the meantime. My neuro has already tried the lot on me; beginning with the Triptans, baclofen, toradol, IV migraine cocktail in hospital, steroid taper pack, IV and IM DHE, occipital nerve block, Iāve even been put to sleep with ketamine! The options are running low and Iām beginning to think the Mav dizziness is not something that can be treated acutely in the same way that typical migraine with pain can be. Anyone had any success? I will say that Iāve had symptom improvement with the benzos but was still holding onto hope that some miracle might knock this out. Also my neuro is a very smart guy but deals more with typical migraine and I feel like heās using the same protocol on me. I know some of you see MAV specialists who deal with this all the time, do they ever try acute stuff or is MAV the beast that is only tamed through preventatives?
My MAV is acute. However, I donāt take meds as an abortive, I take preventatives (pizotifen) that are mostly about 80-90% effective. Iām not sure this helps you. I do hope you find something that works for you.
100%, no. Good enough to function, yes.Standard migraine acute meds are pretty much useless for me, too. The best meds Iāve found are light sedatives that calm the hyper, over-reactive brain. For me, this is meclizine (dramamine, bonine), some anti-emetics (my favorite is compazine), and fioricet (a barbiturate/acetaminophen/caffeine mix). Some folks also use amitriptyline as a rescue med. I have it, but havenāt tried it yet because anything that monkeys with my glucose metabolism (all the anti-depressants) leaves me feeling awful and unbalanced for days.
If the migraine meds donāt work then one is perhaps not dealing with migraine. My symptoms respond to benzos too, no migraine med has ever worked for me.
I donāt know. I think the theory of a lot of migraine meds is about vasoconstriction. If vasodialation is not in fact the only factor, it might not be that the migraine diagnosis is wrong so much as the methodology of treating it. No question whatsoever I have migraine of the classical, brain stem aura and vestibular variety. My meds are working on a different mechanism than the vaso model.
Not convinced weāre using the right terminology here?
Acute denotes a condition of short duration. If MAV was acute, who cares, just ride out the single storm and move on, right? MAV is depressingly chronic though 
Something that flairs up can be called āacute on chronicā apparently, or simply ārecurrentā.
More here: Acute (medicine) - Wikipedia
There is so many variations with MAV. Might there be some confusion because some people think of āepisodicā as being āacuteā? Good term though, āacute on chronicā which would be like when I was already 24/7 dizzy, ie āchronicā but following the MRI Scan had a full on attack that lasted eight days on top of the chronic. I was once referred to as having ārecurrentā vertigo. āRecurrentāā has to be āepisodicā, cos if it doesnāt go away, it cannot ārecurā? Can get to be a bit of a muddle once you start thinking about it. Helen
You are on spot on there. Many consultants limit the number of dizzy patients they are prepared to see in a day. They find their lack of ability to help too frustrating. Dizziness isnāt that well understood. There are no specific medications for dizziness. Buccastem used to carry a note that it relieved ādizziness; in its PIL in the UK but thatās been removed quite recently. Itās great for nausea but did nothing for my Migraine Related Dizziness.
Iāve seen both a top neuro-otologist and a specialist MIgraine Specialist Neurologist and both recognized a migraine element and suggest the usual migraine preventatives, just as if it was straight classic migraine. The Migraine Specialist thought Sodium Valproate better for the dizzy aspect (I havenāt tried it) . And she wrote a paper on Ketamine and Migraine. So thinking about it I was treated just the same as a straight migraine patient and I donāt even experience migraine headaches ājustā vertigo which can be so bad Iām unable to stand. Helen
I think migraine is an umbrella term for what is going on. The mechanism of action could vary greatly from person to person. In my case any meds that work on vasodilation and constriction have failed me. However the central nervous system depressants like benzos seem to help. So I think at least for me itās more of central sensitization/hypersensitivity. Itās also easier for me to believe that my brain is in a constant heightened state of sensitivity than it is to think I have a 24/7 āmigraineā. I see more similarities with my MAV and fibromyalgia than I do with traditional migraine, if that makes senseā¦
Yes I agree. I think āmigraineā is the state you get into as the neurological crisis escalates.
I think thereās many different causes here and itās surely either āmore noise from peripheral sensesā thatās upsetting the brain, or central deficit leading to greater intolerance of normally healthy levels of peripheral noise or in worst case a mix of both issues.
And this could be secondary: you might have one of those issues because of something unrelated thatās wrong with you (or letās just say āsub-optimalā enough to breach healthy limits.).
The Migraine Specialist Neuro I saw as good as said that to me. There never was any mention of it being a 24/7 āmigraineā, or the vertigo being āan auraā. āEverythingās gone a bit hyperā. She said. As I stated above mine was extreme light sensitivity rather than noise. Interesting I remember āgooglingā ācentral sensitisationā long before I ever had a MAV diagnosis. Iāve posted the links on here before.
Have you read this one?
I kind of cruised through the comments, but wanted to suggest getting vestibular therapy if they havenāt tried that yet. I wished I had learned about it years ago. My former ENT gave me a handout with exercises, but they werenāt as focused as what I have now and I just did it for a while and stopped.
The exercises from vestibular therapy were more focused and learning how to do the exercises correctly has helped. The very simple exercises are a lifetime thing, not just what you do for 6-8 visits in therapy.
You can probably find some on the internet, but when I first started I was really shaky with the balance and walking exercises so highly recommend getting the therapy if you can.
Helen - thanks for sharing, thatās by far the most comprehensive migraine guide Iāve read thus far. Explains everything perfectly. I found really interesting right away that it stated migraine is no longer thought of as blood vessel activity but a disorder of nerve activity. And from there itās much easier to understand how every sensory input gets misinterpreted. Lately I have also been dealing with debilitating fatigue and what do you know, itās common in a majority of chronic migraine sufferers. So much more than just a headache, in fact for me, itās everything but!
Certainly is. My favourite by far. Offers all manner of hypotheses to get you thinking. Helpful in so many ways it is. Helen