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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes dizziness when diagnosed with vestibular migraine?

Answered by
Dr.
Dr. Lekshmi Rita Venugopal

General & Family Physician

Practicing since :2012

Answered : 3086 Questions

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Posted on Wed, 3 May 2017 in Brain and Spine
Question: Today I had a videonystagmogram/eng to find out why I have been having dizziness. The dizziness causes me to stagger when I walk and comes and goes. The doctor said she thinks the dizziness is caused by migraines even though I haven't experienced a headache with these attacks. Is this possible? I also have panic disorder and wonder if the balance issue could be related to that. The only other symptoms I have of panic disorder are episodes of losing my breath feeling like I've been running just from walking across the floor. I'm puzzled why this new symptom has appeared. I've had a history of migraines but they are not nearly as severe as in the past. This dizzy/off balance feeling started about a week ago. Sometimes it's bad enough that I bump into walls and feel like I'm going to fall. I have had a hard time walking down steps for a long time but it is much worse now. I don't know what to think. Have you heard of this diagnosis before? I don't have to move my head for this feeling of spinning to occur. That would seem to rule out bppv, although the doctor said that may be a contributing factor to my dizzy feeling.
doctor
Answered by Dr. Lekshmi Rita Venugopal 3 hours later
Brief Answer:
Possible diagosis: Vestibular migraine

Detailed Answer:
Hello,
Thank you for the query at HealthcareMagic

vENG (video electronystagmography) is very effective in the diagnosis of Migraine associated with vertigo or vestibular migraine.
Your doctor must have confirmed the diagnosis of vestibular migraine with vENG.
Vestibular migraines are not always accompanied by a headache. And as your doctor mentioned, BPPV can also be a contributing factor for the dizziness/vertigo in many people with vestibular migraine.

Management of vestibular migraine is mainly by effective treatment of a migraine and vestibular rehabilitation exercises.

Here are few things to help prevent migraine attacks
-Avoid triggering factors like bright light, loud sound, lack of sleep, being hungry etc
-Eat frequent small meals. Never get hungry. Avoid processed sugary food
-Avoid coffee, chocolate or any other food that trigger your symptoms
-Get adequate rest and sleep. Avoid stress and try relaxation techniques like meditation
-Do the exercises as prescribed by your doctor.These exercises are also effective in treating BPPV
-Discuss with your doctor to see if medications to treat migraine like beta blockers, anticonvulsants are right for you.

Hope I was able to help you
Please address further questions/concerns
Regards,
Dr.Lekshmi

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Lekshmi Rita Venugopal 8 hours later
I have been diagnosed with vestibular migraines. My nephew also has migraines but he has seizures, personality alteration and hypersomnolemce. His daughter suffers from periods of disorientation, personality changes , overwhelming urge to sleep, and memory loss of events during an attack All these symptoms are attributed to migraine. Is that the possible cause of these bizarre symptoms. Does migraine run in families?
doctor
Answered by Dr. Lekshmi Rita Venugopal 3 hours later
Brief Answer:
More possibility of a seizure disorder, need EEG to confirm

Detailed Answer:
Hello,
Thank You for following up

Both complex migraine and epilepsy (chronic seizures) have overlap of several symptoms which makes diagnosis difficult.
Both Migraines and seizure disorders have genetic predisposition (run in families).
However, with the symptoms your nephew's daughter is presenting, I would like to look into a seizure disorder like complex partial seizures or a sleep disorder like Narcolepsy.
Confirmation of diagnosis can be made with EEG (Electroencephalogram) and Video EEG.

There is also overlap in treatment of both seizure disorder and migraine. Both can be treated effectively with anti seizure medication.

Hope I was able to help you
Please address further questions
Regards,
Dr.Lekshmi
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Lekshmi Rita Venugopal 14 hours later
I take maxalt for migraine headaches. Will it help vestibular migraine? Will it help the vertigo I experience?
doctor
Answered by Dr. Lekshmi Rita Venugopal 24 minutes later
Brief Answer:
Maltrax not effective in treating vestibular migraine

Detailed Answer:
Hello,

Maltrax will not help with vertigo.
Maltrax is used in treatment of active migraine headache ie, once you get a migraine headache.

Medications used long term that prevent migraine from happening like antidepressants (amitryptiline), beta blocker, anti seizure medication (like valproate ) is needed for the management of vertigo.

Hope I was able to answer your question
Please feel free to address any more concerns
Regards,
Dr.Lekshmi
Above answer was peer-reviewed by : Dr. Remy Koshy
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