Could I have MAV?

I have been doing research on Migraines and Vertigo and I believe I may have MAV. I plan to make an appointment with a neurologist to confirm or disprove this.

My history:
vertigo since childhood with bouts of vomiting. I remember one of the earliest episodes being around age 8. As a child, I only had the vertigo about 1 or 2 times per year. My parents didn’t really think it was anything and it was never mentioned to a doctor.
I have a LONG history of motion sickness and still do. Occasionally mentioned to the doctor to get meds for trips.
I am now 37 years old and around 1995 (age 26) I started to have episodes of vertigo again. Sometimes the vertigo is mild and fleeting, sometimes it lasts for days. I also started to have episodes of extreme veritigo (thankfully, only about 1 time per year) where I became photophobic, sensitive to all motion and had nystagmus (jumping eye movments). These extreme episodes last for several hours, come on without warning and afterward, I am exhausted. I know something has happened. These episodes are extrememly debiliatating. When the vertigo first started in 1995, I went to the doctor and he treated me with meclizine which did and still does help a bit. He said the change in weather patterns can affect some people. When I told him about the severe episodes later on, he blew them off.

I usually have more episodes of vertigo in the fall/early winter than any other time of year, but it can happen anytime, its just much worse in the fall.

Back in late November of 2005, I had my first Migraine Headache with visual aura. I am an Optometrist and I knew what was happeneing when the aura started, even though it still scared me. Initially, I had no headache. Flickering, zig-zag lines started to enter my left visual hemifield of both eyes from the top and eventually filled the entire left hemifield of both eyes then gradually started to go away. The entire aura lasted about 15-20 minutes and was followed by an extremely bad headache, nausea and photophobia. I went to the doctor and he told me I did not have a migraine. I haven’t been back to him since because I know this was a migrain. I didn’t have any symptoms until about 3 weeks ago when I had another migraine headache. Then 10 days later I had yet another, which was the absolute worst one yet. I haven’t had one in over 1 week now, and I will keep my fingers crossed.

I started to think that the vertigo and migraine may be connected simply because of how I FEEL after both events. It was the same (ok, so its not scientific). When I started to research this, I learned of MAV for the first time and it started to sound like it may be what I have suffered from most of my life.

I plan on making an appt with a neurologist and would love any feedback I can get from anyone here.

Sharon

Sharon,

Your history suggests migraine. You have all the classic symptoms. I’m surprised a Dr would say you don’t have migraine with your history and symptoms. I’m no Dr but I can’t think of what else it could be. Your visual aura says its migraine. I have had only one of those. There is a history in my family of migraines, my grandmother suffered form them when she went into menopause. I feel like mine were triggerd when hormones started fluxing. I don’t know where you live but I would look up a Dr on the net who deals with mav. I was dx by Dr Battista in Chicago he writes an artical that is on the site here.

I would find a Dr who deals with this disorder, it really sounds like this is what you have.

Charisse

It’s funny how often people with MAV only have one or sometimes just a few episodes of typical migraine yet have major problems with migrainous vertigo. I notice this all the time - in myself for example I only remember one episode of typical migraine with aura and that was around 13 years ago. Your history actually sounds a lot like mine overall but mine progressed to become chronic, daily and the episodes of spontaneous vertigo have become further apart.

Unfortunately the way your doctor has dealt with you is not uncommon, and there are even neurologists out there who just as unhelpful. Try not to let the bad ones shoot down your efforts.

Regardless of the fact that you’ve had a typical migraine, there are no other causes of recurrent spontaneous vertigo with your pattern. For example, Menieres Disease requires progressive hearing loss for diagnosis. Episodes of vertigo caused by VN/Labyrinthitis might occur once or twice at most, and linger (sometimes for years) but do not cause recurrent discrete episodes of spontaneous vertigo. BPPV causes acute spinning episodes of vertigo that occur with positional changes and the vertigo lasts under a minute (dizziness may persist).

You’d be surprised how common migrainous vertigo is too - one of the articles on this site by the best researchers/doctors in this field put the prevalence of migrainous vertigo at approximately 2-3%. This refers to both the chronic daily form of MAV and those with discrete episodes like yours (much more common).

You should be able to deal with these episodes perhaps with an abortive migraine drug such as sumatriptan (Imitrex) - although that often fails (and is certainly no use with those of us with the chronic form). The alternative then is daily preventative medication - plenty to choose from there.

If you haven’t read the e-medicine article on migraine-associated vertigo (on the front page of this site), it is probably the best place to start!

Adam

thank you for the feedback. I am fairly convinced that I have MAV. I live in NY, just outside of NYC, so I should be able to find a good neurologist (at least eventually).

I also dont believe I have Meniers, I have no hearing loss (that I know of).

Its actually somewhat of a releif to find out that I may “just” be having migraines. Not to be minimized of course, but to konw that what I have has a name.

I am personally more in favor of abortive drugs. Since my episodes are not that frequent (thankfully),I dont want to open myself to the potential side effects of the propylactics. However, in the fall, propylactic drugs may be a better choice since I do have many more episodes.

Sharon

Let us know how you go! It’s not often I come across someone who has discrete episodes of vertigo - most tend to seek out the forums once their symptoms are chronic and occur daily. I would be really interested to see how abortive drugs work for you (esp. the triptans) because they are not particularly useful in the chronic form but I have read about some success in using them for spontaneous episodes. When I get episodes of spontaneous, room-spinning vertigo its full fury lasts 2-3 days (48-72 hours) and I am then left with some residual positional vertigo and nystagmus and that general “sick feeling” for a further few days. I would give anything to abort those as they are debililtating and painfully long (I am unable to walk).

Another option is a lot of neurologists and neurotologists are pushing the use of Vitamin B2, CoQ10 and Magnesium in migraine/MAV patients. As they obviously have a very low side effect profile, and have shown some efficacy they are gaining popularity as something worth trying.

Adam

Adam, I will definitly let you know what happens. I have started to research local doctors. There is a Headache clinic at Monetfiore Hospital in the Bronx. Manhattan would be better, but I will go where they have the services. I looked into Westchester medical center and one of the top neurologists in the dept has written many aritcles, but way too many of them comment on obesity as a connection to migraine. I have had everything blamed on obesity (yep, even the ear infection at age 14) so I automatically scratched him. Its a “thing” with me, that I wont stand for anymore.

I am interested in the supplements. In my research I have come across a lot of data about the Magnesium and B2. I didn’t hear anything about the use of CQ10. What is also interesting (at least in my case) I had RNY Gastric Bypass surgery 15 months ago. If you are unfamiliar with this, it is a weight loss surgery procedure that restricts the amount of food you can consume as well as causes you to malabsorb some of the food you eat. Supplementation of vitamins and minerals after surgery is an absolute necessity. I take many, many supplements including magnesium and B-complex (among others). The first Migraine Headache with visual aura happened in Nov 05 (6 months after my surgery). The episodes of vertigo have been much longer. So I guess I am wondering if my decreased nutritional status had something to do with it. I started to take more Magnesium citrate in addition to whats in my calcium citrate. I have also started to take a second B-complex supplement. High doses of B vitamins are relatively safe since they are water soluble.

There was a conversation on a gastric bypass board about migraines recently. Many of the people there who never had migrains before started to have migrains after their surgery (they are being told there is no relationship, however, the headache community might beg to differ).

I never thought I would say this, but readin just how badly peoples lives have been disrupted by more chronic vertigo, I guess I am glad mine is episodic. The closest I have to anything chronic is in the autumn when vertigo and dizziness are very, very frequent and severe for me.

Sharon