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Migraine-Associated Vertigo (Vestibular Migraine)


NB: suggest you do not read this if you are prone to anxiety wrt medical information or going through a rough patch.

“An additional study showed some fascinating associations between Meniere syndrome and vestibular migraine. Thirteen percent to 18% of those initially diagnosed with probable or definite vestibular migraine developed bilateral, low-frequency sensorineural hearing loss within 9 years. Interestingly, 7% to 11% developed cochlear symptoms that met the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS) criteria for bilateral Meniere syndrome [12] [6].”

" Finally, one study showed that caloric testing triggers a migraine in some individuals. In this study, 39 individuals with a history of a migraine underwent caloric testing. Within 24 hours, 19 of these individuals developed their typical migraine symptoms. 47% of those that developed a migraine within 24 hours actually developed a migraine during testing. This study design used a matched control group and only one of 21 from this group developed a migraine within the initial 24-hour period after testing [18]. This finding is perplexing, leading one to believe that peripheral vertigo can be a trigger of a migraine or migraine-related symptoms."

(that last statement is something I’ve been advocating all along …)

Help me.

Interesting paper. What really stuck in my mind was two statements. The first that mean age for onset of dizziness was shown to be 49, and the second that it is an necessity to treat accompanying anxiety. Helen


It certainly triggered me to expel my lunch.

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I was warned not to have lunch. Good thing, too. So nauseous and yes, instant migraine.


Yeah, I actually think it was best that they didn’t warn me of that test. I had no idea going in that they were going to essentially give me 8 shots of tequila.

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Sort of like trying to do your taxes while on a tilt-a-whirl next to a rock concert in a disco.


I was beyond terrified before my first vng/calorics test. But I was fine both times for some reason. The vertigo elicited by the calorics test was not unpleasant to me, and felt like an amusement ride. It also showed me that is not the type of vertigo/dizziness I get. Mine is more rocking/tilting- walk like a drunk, and bursts of the “magneto head” pulled to the ground feeling.

@turnitaround, I also think that hydrops is the underlying cause for much MAV. I’ve had SSNHL, fluctuating tinnitus all during periods of no other symptoms of migraine. And all mostly during Spring. I do get basilar migraine too.

Last I read, Hain thinks migraine/Menieres may be a spectrum of the same disorder. I will have to go back and check, as he updates his theories as more data/experience develops. That’s what I like about him- willing to change his view based on what he sees- nothing written in stone. As a matter of fact, I was surprised to recently read that he’s updated his opinion of the existence of Cerviogenic dizziness. He admits he’s seen it more, and it is a viable cause of some dizziness.

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I read that somewhere on his site but he seems to have removed that statement since or I simply can’t find it anymore.

Yes. There’s surely related anatomy? I had three basilar style migraines in the early days but after going on Amitriptyline they stopped dead. I was really lucky there as those things are shocking and totally life disrupting.

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@turnitaround You appear to be correct! It looks like he’s backed off of that theory. Again, it pays to check his site frequently. It’s one of the rare ones that updates with new thinking/findings.


Sooo, have any of our past or present MAVers here had luck with the addition of low sodium protocol given to Menieres patients?

I tried it when the Dr at Stanford told me that I may have hydrops, and may progress to Menieres ( subsequent Dr’s have disagreed with that diagnosis). It did seem to help a bit, but was very difficult for me to follow. I found steroids to be the best treatment.

My acute attacks seem to be migraine, in my and my neuro’s opinion. I have Neuro symptoms as well as vestibular, like not being able to find the right words and uncoordinated walking… It is my understanding that this points more to basilar migraine than Menieres.


Btw my doctor, a professor at a teaching hospital wouldn’t be drawn on why but he states that secondary hydrops presents with the same symptoms as migraine associated vertigo. That’s certainly my observation too. He also recommends the same dietary restrictions. Draw your own conclusions.


Actually i do the opposite of low sodium. I add a little pedialyte(Electrolyte) into my water bottle and drink all day from it. It helps with the migraines. Especially it helps me go longer between meals without triggering a migraine.

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I don’t have an issue with salt either from what I can gather. MSG though, definitely.


Nitrates, soy and red wine are the worst for me. And anything highly processed.

Too much salt makes my tinnitus WAY WAY worse, but hasn’t seem to bring on dizziness when I’m not already dizzy.

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Interesting !


@GetBetter it’s not uncommon to have tinnitus worsen from too much salt, as I’ve seen it mentioned tons of times on various tinnitus boards. Ive always assumed it was a blood pressure thing or something. But I only have tinnitus in my left ear, so I assume there’s some abnormality there that makes it more sensitive to fluid balance… Idk. No one knows.


Do you have any low frequency hearing loss ?


I just looked at my audiogram after I recovered from the SSNHL back in 2015 (During SSNHL it was pan frequencies). Looks like my hearing returned to almost baseline, with slight loss in the high frequency. I believe it has remained unchanged since then.


Plus I’ve never had true rotational vertigo (like during the calorics test). Both ears had even, robust response both times (1st in 2015, 2nd in 2018).


Never rotational for me. I am a rocker !

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