I’ve been coming off a tricyclic (Dothep) 100mg down to 25mg at present. I’ve taken 6 weeks to titrate down. Last week I began to get a lot of vertigo and balance problems again. Still on 100mg Topamax and wondered whether this new stuff is a reaction to coming off the anti-depressant or whether, in fact, the Dothep was helping far more than I realised.
Emailed Dr Granot to get his opinion - his suggestion was BPPV! Dr G said to drop in early next week & he would fix it -obviously forgot 2,500km was a long way to “drop in”! - still the offer was good! I was very sceptical. Had many ‘Epleys’, ‘Hallpikes’, etc when MAV first hit - never any nystagmus. Of course, Saturday morning - GP didn’t know how to do the manoeuvre, physio unavailable so Googled, found decent u-tube video and, I’m still ‘gob-smacked’, my husband did the Epley, nystagmus present, and all fixed up!
So how, after three years and quite a few instances of fairly sudden onset of dizziness, falling over, balance issues etc did Dr Granot pick BPPV?
Barb
You can treat this all by yourself. I’ve used it myself and cleaned up a BPPV attack in 2005. I saw Halmagyi days later and he confirmed that I had cleared out the rocks.
See this post here that discusses the Modified Epley Procedure or MEP.
Thanks for the info Scott - I did try the video link but can’t open it in my ipad. The printed info is useful tho. I didn’t realise I need to keep doing the procedure 3 times a day for a week! In fact, wondered why the dizziness had come back this morning!
How did Halmagyi know yours had cleared up - can they actually see anything in the ear? Mine seems to be in my right ear - I’ve had fullness in that ear from the start of MAV and is definitely worse at the moment but not sure that’s connected to the BPPV.
Krystal - no, didn’t happen when I rolled over in bed, started when I bent down to feed our dog!! :roll:
As to why Dr Granot thought BPPV is the problem I haven’t asked (yet). He has my whole history and have been in reasonably frequent contact with him since November 2010. I’ve been doing well since being on 100mg Topamax for three months but because of anxiety/panic attacks have been titrating slowly off Dothep with minor side-effects. Possibly, the sudden onset of the vertigo when putting head down, losing balance, falling forward and unsteadiness when walking was a ‘flag’ when everything else was ‘calm’.! Haven’t been in such a good place for so long then this happens - hope mine clears up as well as yours did!
Barb
What I’m wondering is why he would have suggested BPPV at all. It seems more likely a return of migrainous vertigo with the drug reduction no? Perhaps your threshold has dropped – as in you are not as tall in the migraine pool at the moment and the water level is hitting your nose again. BPPV should be causing discrete nystagmus with head movement. When you keep your head still, it should “fatigue” and stop. The eyes pulse in the direction of the affected ear. Is that what you have been getting?
Yeah, that mpeg doesn’t seem to work very well from this site or from the journal. Hopefully you can get the gist of it viewing the photos.
Halmagyi just threw my head around in a bunch of positions and said there was zero nystagmus so all cleared up. I (touch wood) haven’t had BPPV since.
You can treat this all by yourself. I’ve used it myself and cleaned up a BPPV attack in 2005. I saw Halmagyi days later and he confirmed that I had cleared out the rocks.
See this post here that discusses the Modified Epley Procedure or MEP.
It was all I could do watch this, let alone do it!! I can’t believe people with VM - even with an episode of BPPV - can do this and survive!!! Really? Scott and Barb, does it not make you feel out of control dizzy as you do it? I’m flabberghasted. :?
Scott,
I found a local physio who has given me a couple of session using the Epley manoeuvre. This has worked really well for me!
Having the neck at the right angle & over the end of the treatment couch (well supported) apparently gets the ear canals at the right angle to move the crystals.
Brenda - Must say I was really sceptical that it would actually make any difference having had this procedure many times early on in my MAV and just making me even more dizzy. The physio did say he couldn’t see any nystagmus although my husband had seen it when he did the manoeuvre the first time.
Another thing that puzzled me - the physio didn’t think that BPPV sufferers got ‘ataxia’. Although it did improve after the treatment it is still an issue. I also think it’s possible the BPPV has triggered the Migrainous Vertigo increasing symptoms.
I asked Dr Granot why he thought my problem might be BPPV and his reply was:
"I thought it could be so because you described it as positional. it does not sound like migraine as such. "
Barb, don’t know whether you still read this, and hope you are feeling better these days.
I’m convinced my MAV was BPPV triggered, and in fact is fundamentally BPPV at its heart. I’ve had really obvious BPPV symptoms on many occasions (positional, spinning vertigo). I’ve had sensations/sounds of dripping and gargling fluid in my ear as if the fluid is negotiating a blockage (and this has actually seemed improved over time as if the blockage has reduced). I note Hain states that BPPV can give you migraines.
btw, should have thought that amount of antidepressant could easily give you reversible ataxia.