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Suggest Treatment For Symptoms Of Migraine

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Posted on Thu, 2 Feb 2017
Question: For the past three weeks I have been suffering from a strange condition that makes me feel light headed, tired (on occasion) and a feeling or sensation that I have a balance bias to the left. That is, that I will fall or stumble to the left if sitting or standing up, or that when walking I will veer off to the left. However I never fall, stumble or veer to the left. I also have what is best described as a feeling of being foggy in the head; like I’m a bit spaced out.

3 weeks ago I had a vertigo attack where my whole world was spinning, so I stayed home from work, rested, and it eventually resolved. However since that time I have had the issues I describe above. I have suffered a vertigo attack before, a few years ago, much worse than this one.

I also have chronic neck and right shoulder muscle problems and have been getting vague headaches. On a scale of 1 to 10 these headaches rate a 2 or 3. They don’t stop me from doing anything and usually resolve on their own. They may come and go during the course of a day. They never wake me in the night and I rarely wake with a headache. I do not experience any nausea or vomiting in association with this. My eyesight and hearing is normal with no double or blurred vision, strange hearing sensation or anything else suggestive of a problem.

When I had the vertigo attack 3 weeks ago, I went and saw my doctor about it, and to discuss the headaches. I was particularly concerned about the possibility of a brain tumour. He did a series of tests on me involving eyesight, shining a light deep into my eyes, hearing, touch, walking with one foot in front of the other, walking forwards on my toes and then backwards on my heels, and another one I can’t remember. He said I was fine and that the headaches are probably tension headaches caused by stress in association with my neck and shoulder issues, and that the vertigo should hopefully clear on its own.

I should point out that this “thing” doesn’t stop me from doing anything. If I am physically active, like doing house/yard chores I do not seem to be bothered by it (or notice it). Tiredness could be due to the Xmas/NYE cycle with late nights and a fair bit of alcohol consumption. Now that I’m back at work I’m limiting alcohol intake to weekends only and resumed going to bed at my normal work week time. The headaches, if I have them, don’t seem to be aggravated by anything in particular. For example, yesterday I developed a headache, that worsened as the day progressed. This is nothing abnormal for me. Occasionally it felt like it was reaching down behind my right eye and circling my eye. I woke this morning without a headache.

I have caught myself out on a couple of occasions struggling to string a coherent sentence together. I am not sure if this is due to tiredness, confusion due to the vertigo-whatever, or something else. Doesn’t happen often but I’ve noticed it. Perhaps I am over-thinking it and trying to make an association with something that isn’t there.

The light headedness and “bias to the left” issue is not resolving and I’d like a second opinion. I have moved house and am not able to easily go back to the doctor I saw last time.
doctor
Answered by Dr. Rini (2 hours later)
Brief Answer:
Vestibular migraine

Detailed Answer:
Hi,
Firstly thanks for choosing health care magic for your query.

Have read all your details ,After reading your history your symptoms and your treatments,The first thing which strikes is either it is vestibular migraine or vestibular menieres disease.

As all your base line tests done by various doctors are normal;i would like to consider it as Vestibular migraines.
A vestibular migraine is a nervous system problem that causes repeated vertigo in people who have a history of migraine symptoms. Unlike traditional migraines, you may not always have a headache But is usually accompanied by headache.Tiredness with extreme fatigue and feeling of disbalance are usually the sign of peripheral vestibular lesion(Labyrinth or internal ear).

Second possibility is Vestibular menieres disease.
Formally, Meniere's disease is characterized by (1) unilateral sensorineural hearing loss, typically fluctuating and predominantly in the lower frequencies, (2) tinnitus, constant or intermittent with the hearing loss typically increasing in intensity before or during the vertiginous attacks and, (3) attacks of vertigo lasting minutes to hours with irregular intervals, and accompanied by nausea and vomitting.However vestibular menieres is a variant of menieres disease in which symptoms of vestibule are prominent like dizziness,vertigo and disbalance and cochlear pathology like hearing loss and tinnitus are absent.

Test recommended-

Caloric stimulation of ear
Vestibular evoked myogenic potential;(VEMP)
Pure tone audiometry (During the attack of vertigo)
Bera
EEG brain to differenciate between vestibular epilepsy and migraine.

Advice
FOLLOW UP WITH NEURATOLOGIST(expert in inner ear problems).
Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Rini

Cardiologist

Practicing since :2010

Answered : 140 Questions

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Suggest Treatment For Symptoms Of Migraine

Brief Answer: Vestibular migraine Detailed Answer: Hi, Firstly thanks for choosing health care magic for your query. Have read all your details ,After reading your history your symptoms and your treatments,The first thing which strikes is either it is vestibular migraine or vestibular menieres disease. As all your base line tests done by various doctors are normal;i would like to consider it as Vestibular migraines. A vestibular migraine is a nervous system problem that causes repeated vertigo in people who have a history of migraine symptoms. Unlike traditional migraines, you may not always have a headache But is usually accompanied by headache.Tiredness with extreme fatigue and feeling of disbalance are usually the sign of peripheral vestibular lesion(Labyrinth or internal ear). Second possibility is Vestibular menieres disease. Formally, Meniere's disease is characterized by (1) unilateral sensorineural hearing loss, typically fluctuating and predominantly in the lower frequencies, (2) tinnitus, constant or intermittent with the hearing loss typically increasing in intensity before or during the vertiginous attacks and, (3) attacks of vertigo lasting minutes to hours with irregular intervals, and accompanied by nausea and vomitting.However vestibular menieres is a variant of menieres disease in which symptoms of vestibule are prominent like dizziness,vertigo and disbalance and cochlear pathology like hearing loss and tinnitus are absent. Test recommended- Caloric stimulation of ear Vestibular evoked myogenic potential;(VEMP) Pure tone audiometry (During the attack of vertigo) Bera EEG brain to differenciate between vestibular epilepsy and migraine. Advice FOLLOW UP WITH NEURATOLOGIST(expert in inner ear problems). Thanks