Can MAV mimick BPPV?


General question. Can MAV mimick BPPV? I have had positional vertigo, but my ears also ring without hearing loss.

Since I am very young and more of a candidate for MAV then BPPV, I was wondering if migrainous vertigo could be positional and last two months.

Yes, I’ve been tested multiple times for BPPV thinking I had it or a doctor wanted to rule it out, negative every time.

I don’t have any confidence in the current diagnosis set of ENT. I dont think they have a clue what is going on half the time. Symptom management and time is the best healer imho. It took me 1.5 years to finally get a diagnosis that made sense and up to that point I was told I had MAV. MAV is such a fanciful idea (migraine causes 24/7 dizziness, imbalance and tinnitus?!). I believe in time MAV will be shown to be something very different …

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How would I know if it’s bppv or migraine ? After the epley the spinning stopped but I have residual dizziness off balance and still get migraines.

Well, imho, migraine as a cause of vertigo doesn’t exist, but its a very common symptom with ear trouble. I really don’t see how migrainous vertigo could be positional. The whole thing is simply fantasy.

I wouldn’t dwell too much on diagnosis. A lot of ear trouble is known to clear up of its own accord but can take months or years. I’m starting to get much better and its taken me OVER TWO! I would focus in the meantime on what makes you feel better, so try some medication to see what eases symptoms, consider Amitriptyline or Noritriptyline, or whatever your ear specialist suggests.

I am going to see an ENT on monday. Hopefully I get some answers.

Good luck. I’ve had a leak in my ear for over 2 years and I was told this was migrainous vertigo by some ENTs/Neuro’s.

Migraines cause your ears to leak?! Really?!


This is the most depressing part is that even some specialists don’t have the answer.

My migraines could be totally unrelated to BPPV and vice versa. How did you fix your ears?

Well its my left ear (that’s another thing - so migraine chooses an ear? tell me another one! I’m rolling in the aisles). To fix it I’ve simply done 2 things:

  1. been very patient as its an area of the body which takes AGES to heal due to the pressures involved (air and fluid).

  2. I’ve followed the post op guidelines on how to treat fistulas that have been patched … these include never bending down past your waist, having two pillows, no holding in sneezes, no singing or horn playing. I’ve also not use headphones for very long for a few months. And finally no straining lifting big weights.

Ear trouble causes a big mess in sensory information to the brain and the brain goes into a migraine state, its that simple. Dampen the signals with meds and you avoid the migraine and reduce the dizziness.

Would you think it’s normal then to take a while with residual dizziness after bppv? I had bppv for two months before it was diagnosed

Forgetting for a moment the specific diagnosis (i’m also suspicious of BPPV as a diagnosis because it doesn’t have a very good explanation either) assuming you have some kind of ear trouble, yes it would be completely normal for imbalance to hang around for a while. From what I’ve learnt I don’t think ear trouble is a life sentence for most, its just a very upsetting phase … be patient, the body is great at healing! :slight_smile:

Why don’t you believe the bppv? I know th otoliths thing is a hypnosis only. But why does the epley work for so many people?

That’s true, you have a good point there. Be nice to know exactly why it works though :slight_smile:

For me, the manoeuvre only made things worse, really really worse. I was recommended to try it by an ENT, and she even said to try it for a long time, say 6 months, if it didnt “work” at first.
I quit doing it. It got so bad. I felt a coward.

Only my later neuro-oto told me that the Epley (and other manoeuvres) is (are) contra-indicated when MAV is at play. So in some cases (like mine) it can be very clear: it gets worse due to the manuoevre, so it is no bppv.
NB: This is NOT a recommended diagnose-method.

Then there is PPPV or CSD, or the effect in the brain of the vertigo-episodes -even though they can be caused by different things originally. This is explained to me (aka the patient) as a"software-glitch" of the brain, or more precisely the equilibrium-sensory-information-processing bit of the brain. It lingers on, so to say. This may need time, excersises (vrt) or just practice (daily life) can do some good, but one needs to go gentle and not cause a new panic or over-stimulate that bit again.

Goodluck getting there!

That’s the thing. I read some research online where doctors performed autopsies on people who had BPPV and did find the calcium crystals in the wrong place.

When I did the Epley, I would get intense spinning on my right side, so I knew it was positional. I also would get dizzy spells during the day if I held the phone on my right side as well.

After I had performed the Epley and the Half Summersault, there was no spinning anymore. But I am left with this off balance, rocking, floating sensation and still some very minor positional vertigo. When I hold my phone or lie back on my right, I have this sensation like I am about to spin. My feet start getting shaky, and the anxiety feeling comes back with a sense of intense floating but no spinning.

My vestibular therapist believes that because my brain has been receiving mixed signals for two months, it will need time to recalibrate.

It has been slowly getting better, but then there are little setbacks. For example, this morning I woke up and I feel heavy headed, ears buzzing and I am dizzy. I also have a lot of mucus in my sinuses.

About one month before my BPPV started, I had bronchitis that just never went away. But that wouldn’t contribute to calcium particles getting dislodged. I also slept on one side (my left side) my entire pregnancy so that wouldn’t equate to my right side is affected.

Another thing I am leaning towards also, that may play a small part in this, is my teeth grinding. Do you guys believe constant grinding can cause ear inflammation?

I also notice that my off balance and vertigo feelings usually come on during stressful periods so perhaps high-stress, inflammation, and hypersensitivity cause this. But then again, that wouldn’t play into the calcium crystals moving hypothesis and the Epley being useful.

Not knowing full context but “crystals in wrong place” would not give you spinning sensation. Something has to be connected to the neurons to send information to the brain. Crystals are simply dumb bits of mass. A clot of some kind that’s causing a greater than normal perturbation is the more likely cause of BPPV. And like I said, the labirynth has dark cells to which debris including loose crystals are supposed to stick, harmlessly.

Another possible cause of positional vertigo is leakage. The higher your head pressure the more likely your inner ear would experience a leak if there was some kind of fistula. Hence the leak be worse in some positions. That’s why I believe some people including myself get spins in bed. The head experiences greater pressure when lying down than when standing up. The movement of fluid caused by the leak stimulates the sense that would normally only be stimulated when your head moves. The bigger the leak the more violent the spin experienced. If a leak is present the ear reacts with over pressure in the form of Secondary Hydrops. This in itself can cause the fistula to open and leak again.

I believe the grinding teeth causes TMJ. My buddy had one of the worse cases the dr had ever saw. You will have to look it up cause I can’t exactly remember but it has to do with the nerves around the ear. He started to get so bad that he could hardly walk because of the off balance and dizziness. The dr gave him a mouthpiece to wear at night to stop the grinding and that’s all it took to cure it.

Not just grinding. My TMJ came on due to the muscle clenching exercises I had been given by my therapist to help me relax! My jaw went into spasm. The key to avoiding or fixing TMJ is relaxing the jaw muscles between meals. Some people tend to fidget with their mouth.

Mouth guards are a fabulous way for dentists to make money. Perhaps they help some but mine made it worse. I stopped using the guard after a few days and not looked back. My TMJ has improved over 12 months significantly just by following basic advice:

  1. Relax jaw between meals, don’t fidget with your mouth or grind teeth. Don’t try to get food out of your teeth with your tongue, go brush!

  2. For first month liquidise food, then go easy for a while, cut up food with knife and fork and don’t bite for a few months.

  3. Don’t let your jaw click

I don’t believe TMJ could cause dizziness, your balance nerve is well protected within your skull. This is just another BS story that money grabbing greedy dentists will tell you, enjoying their luxury cars as you struggle …

I had my ENT appointment on Monday and he doesn’t believe in the Epley. He says it’s all bullshit and he has never seen anyone cured with it. What he believes is that yes, there may be debris floating around and the brain has to get used to it.

He says my most probable problem is TMJ and to get a mouthpiece.

He says the ringing and migraines radiating from my ear and eyes are from the grinding. He says there is absolutely nothing else going on.

Last night I realized if I turn my head and do the half summersault and I notice when I move my head a certain way I get post nasal drip. So maybe, as you stated, there is something there that hasn’t yet come out yet.

What do you think?

See, here’s the thing that puzzles me. According to the ENT, the Epley doesn’t work because the ear’s calcium crystals don’t move within the inner ear like a ping pong. They move quite slowly in the fluid.

But I told him that after I performed the Epley and had positional vertigo in my right ear, the world spun like nothing I had experienced before when I sat up.

I had to hold on to my husband because it felt like I was on a roller coaster.

He said I may still have junk in there that hasn’t come out or moved away or even dissolved.

Last night I decided to eat solid mango chunks, the chewy kind. Well, I feel dizzy again, like off balance.

I also notice that when Ido turn my head and make myself dizzy I get a sort of post-nasal drip and I don’t remember this being normal.