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Noise in head associated with position change and eye movement. Is it a variant of migraine?

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I experience a brief noise in my head associated with position change and eye movement. It may be triggered by flying (airplanes), and scuba diving and is usually associated with vertigo. It sounds like a brief "whoosh" noise, or a sliding door slamming closed. When I'm having really bad vertigo, I can recreate the noise while lying still in bed with my eyes closed by just moving my eyes back and forth. But sometimes it is only associated with very mild vertigo. It's marked and loud! This has been happening quite a bit over the past 2 years, intermittently. Lasts days to weeks. I am 48, 240lbs, 5'5". I also take regularly take BP meds (HCTZ and Losartan), and cymbalta for depression/neuropathic pain (from L3-5 disc injury, repaired, longstanding). I occasional use ibuprofen, albuterol and ambien (as needed). I looked up these meds and this noise thing or intermittent vertigo did not seem to be listed as a side effect. I went to ENT, had an audiogram done (normal), and the ENT did not know what to make of the weird noise thing or the vertigo, and he had never heard of the noise issue. meclazine not helpful. ENT doc considered sending me for head imaging or to neuro and suggested it might be a migraine variant? Any theories?

The symptoms seem related to flying OR diving (not both) but do not always occur with those activities. It is hard to ID triggers. Symptoms sometimes seem like they may be related to lack of sleep, or alcohol consumption, but they also occur spontaneously, without any provoking stimulus (like flying, diving, URI, etc.). Also, I've seen my PCP and ENT... normal neuro exam, normal audiogram, normal ENT exam. I had a routine eye exam at optometrist within past year which was normal. No headaches or focal neuro symptoms with sensation of vertigo and strange sound.
Posted Sun, 6 May 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 13 hours later

Thanks for the query.

Regarding the episodic dizziness or vertigo with sounds in the ears (Tinnitus) which occurs with change in position of the head and pressure changes indicate the possibility of benign positional paroxysmal vertigo (BPPV).

BPPV can be diagnosed by doing a simple bedside test called Dix Hallpike test preferably by Vertigo specialist. If positive, most effective treatment is a procedure called "Epley's maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. If test is negative you need to consider other possibilities and require additional investigations.

Dizziness or vertigo is a common complaint among migraineurs, and can be seen in one third of them suffering from migraine. It can occur with or without headache. Response to migraine medication is the only way to prove the diagnosis.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of a vertigo specialist. CT or MRI of the brain may be required if physical examination suggests intracranial cause.

I thank you again for the query. I hope you found my response to be helpful and informative. I you have any additional concerns I would be happy to address them.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
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