Diagnosed with VN... but maybe it's MAV?

Hi all! :smiley: I’ve been reading here for an hour or so, and thought maybe I would register. I have a lot going on in my head at the moment, and am wondering if maybe someone here could give me their opinion.

  • I have had migraines on and off throughout my life, many lately (I am 40 yrs old).
  • the dizziness thing started with a bang, a year and a half ago… first symptom was the feeling that the floor was tilted… had an awful summer…some better days, but lots of couldn’t get out of bed days
  • never full on vertigo, or major imbalance… more like motion sick, heavy head, dizzy and lots of nausea and IBS like sxs
  • diagnosed with VN after ENG showed 35% damage in one ear
  • started VRT
  • I am completely functional now (and grateful), but have been having 10-15 migraines a month (that’s a lot of Relpax), and go back and forth between weeks of feeling zero dizziness and nausea and weeks where I do. Felt I was decompensating (ie, did too much VRT one night, very sick the next morning… another time I stayed up late, drinking and dancing, and then sick for weeks)
  • I’m not sure Ive ever had dizziness and migraine at the same time… I seem to have one or the other

My question is, could this possibly be MAV? Maybe I had VN and now MAV? A gentleman on the Healthboards has got me wondering if maybe I need to look at other possibilities. I have made an app’t to see my dr in a couple of weeks to discuss preventative meds. Any advice?

I really appreciate anything you have to share. Thanks so much!

Sheri :smiley:

Hi Sheri,

Welcome to mvertigo and sorry you’ve had such a bad time with this junk.

It is entirely possible that you have had a dose of VN or labyrinthitis that caused your “Big Bang” and has now sent you into this chronic state of migrainous vertigo. This is what happened to me. Before the viral attack, I was a migraineur who experienced frequent head fog and coat-hanger headaches. They got much worse as I approached my late 30s and were set off by my diet though I didn’t realise it at the time.

Baloh (UCLA) will tell you that unless a caloric test shows a weakness that is greater than 30%, it is not worth taking into consideration. The test is very crude. However, yours was a 35% weakness and therefore you may have had a viral infection. When it hit did you have any other symptoms besides heavy vertigo? Did you ever have any BPPV during this period?

It is also VERY possible that your condition is ALL migraine. A number of researchers have reported that it is not unusual to observe a significantly reduced caloric response in patients with common migraine headache. Kuritzky et al reported that 22% of 40 ears of subjects with common and classical migraine demonstrated reduced caloric responses. In another similar study, Toglia and co-workers reported that 44% of patients with common migraine demonstrated a significant unilateral weakness on caloric testing. Eviatar evaluated kids with basilar artery migraine and discovered that 44% of her subjects had a unilateral (one-sided) weakness on caloric testing.

It is believed that the migraine may result from prolonged vasoconstriction and poor perfusion of the labyrinth. This would result in an ischaemic (lack of blood supply) injury to the vestibular labyrinth.

If I were you, I’d start by treating the migraine with lifestyle mods and then meds. If it’s all migraine, it’ll correct itself, and if there is some viral damage, you will be able to fully compensate. I don’t see any other possibilities given your migrainous history.

Cheers … Scott 8)

Wow, Scott, I can’t thank you enough for all of that info! Pretty fascinating stuff really, isn’t it?

Whatever it may be, I long to be feeling healthy and happy MOST days, not just some days. I need to make my health the priority right now. I have a read a lot about “Heal Your Headache”… Will check the library tomorrow.

It seems crazy to me that this could be something completely different than I thought it was. But it’s nice to think I might actually have more control than I thought.

Again, thanks a million. I will update, and will be hanging around to learn more from those of you who have BTDT. :slight_smile:

Hi Sheri,

If you haven’t investigated what your triggers might be yet, I’d get onto that first. You may be feeding yourself a trigger load you’re unaware of. You really have to keep a journal to work out what these are if it’s not obvious and even then it’s worth doing because it might be a combination of things or something that never occurred to you. Go after the main food triggers first as these can really cause major problems for some people (like me). Alcohol and caffeine are generally the first two to delete from your diet along with nuts, cheese and aged products. The key is to eat fresh foods and avoid the junk – shop around the perimeter of the grocery store.

You really can have so much more control over this than you think. We just have to get you pointed in the right direction with a dx you can be certain of and then you can start getting your life back.

All good.

Scott 8)

Hi Sheri,

Like Scott, I also had a different problem to start with (in my case BPPV) which seemed to trigger off migraine associated vertigo. I have been a sufferer of headache migraines since I was a teenager, but only experienced problems with vertigo in the last few years.

I don’t really think you have got anything to lose by trying a few lifestyle and diet modifications to see if you can identify triggers. Personally my big triggers are: lying in bed late in the mornings, going a long time between meals, and drinking alcohol. Luckily these are all pretty easy to modify, but even so, I still get plenty of headache migraines, just fewer than I would do otherwise.

In the end, as my balance problems were intolerable, I took medication, and that really sorted it out for me. Interestingly the meds never got rid of my headaches entirely, but I did see about a 50% reduction. But my balance problems have pretty much resolved.

Hi Sheri and welcome,

As you already know you’re a migraineur that’s something you can try and address right now, with the lifestye modifications. If you have any known triggers, cut them out, try and eliminate the very common triggers and adopt the migraine lifestyle - regular sleep, moderate exercise, reduce stress etc. If you have an appointment with your dr already, you might want to get a prescription for something but hold off trying it to see if the lifestyle stuff helps first.

Good luck and I hope you don’t have anything else going on besides migraine. It’s enough to deal with!

Vic

Thanks SO much for all the feedback, guys!

That’s a great idea, Vic… I will get the prescription but wait to fill it.

I am quite sure the following are triggers for me: sleeping later than usual, chocolate, tartrazine, peanuts.

I once drastically reduced my migraines a few years ago by exercising 3x week, drinking more water and taking good supplements (including liquid magnesium, B vitamins and a good multi). Easy enough… I am doing the second two, just have to get back on the fit train. :slight_smile: the other thing that has really helped me (I just need to do it more consisently) is the theracane. I use it on my trigger points in my upper back. When I first started it, it took 3 days to start working. I literally went from more than a dozen migraines in a month to 4. I was amazed. Obviously trigger points are a huge factor for me.

I made an appt today with my son’s naturopath to have IgG done. Have any of you gone this route to try to figure out what kind of foods you are sensitive to? My sons came back with wheat, and (mildly) eggs. The elimination diet is so overwhelming for me. I am a mom of two young kids and life is crazy! If the IgG could make it easier, and faster, it’s worth the price for me. :wink:

Anyway, I will keep you posted on how things go. thanks again for your replies, everyone. Much appreciated!

Wishing good health and happiness to all!

— Begin quote from "lovineachday"

I made an appt today with my son’s naturopath to have IgG done. Have any of you gone this route to try to figure out what kind of foods you are sensitive to?

— End quote

Hi there,

Here’s what the Australasian Society of Clinical Immunology and Allergy have to say about these tests used by naturopaths. I’d save your money and use the proven route in exploring what your migraine triggers are – which requires using a daily journal to record your habits and the outcome in terms of migraine symptoms. Using this test from a naturopath will likely cause you to eliminate foods from your diet that are in fact not problematic.

Best … Scott

[size=140]Food specific IgG, IgG4[/size]

Use: Diagnosis of food sensitivity/ allergy.

Method: Antibodies to food are measured using standard laboratory techniques.

Evidence: Level II

Comment: IgG antibodies to food are commonly detectable in healthy adult patients and children, independent of the presence of absence of food-related symptoms. [size=140]There is no credible evidence that measuring IgG antibodies is useful for diagnosing food allergy or intolerance, nor that IgG antibodies cause symptoms.[/size] In fact, IgG antibodies reflect exposure to allergen but not the presence of disease. The exception is that gliadin IgG antibodies are sometimes useful in monitoring adherence to a gluten-free diet patients with histologically confirmed coeliac disease. Otherwise, inappropriate use of food allergy testing (or misinterpretation of results) in patients with inhalant allergy, for example, may lead to inappropriate and unnecessary dietary restrictions, with particular nutritional implications in children. Despite studies showing the uselessness of this technique, it continues to be promoted in the community, even for diagnosing disorders for which no evidence of immune system involvement exists.

Food specific IgE (RAST, ImmunoCap testing)

Use: Diagnosis of food sensitivity / allergy.

Method: Antibodies to food are measured using standard laboratory techniques. Some laboratories may present data inappropriately as raw counts or as “response factors”.

Evidence: will depend on the clinical scenario

Comment: Inappropriate used may be divided into three areas. (1) Inappropriate patient selection. As with any diagnostic test, use in patients where there is no evidence that food allergy plays a role in pathogenesis increases the likelihood of irrelevant false positive results. Use of food allergy testing in patients with inhalant allergy, for example, may lead to inappropriate and unnecessary dietary restrictions, with particular nutritional implications in children. (2) Misinterpretation of results. Low levels of food-reactive IgE are found in some healthy individuals without clinical reactivity. Challenge studies have shown a correlation between allergen-specific IgE and then likelihood of reactivity to some (such as cows milk, egg and peanut) but not all foods. In the absence of a history of clinical reactivity, low levels of allergen-specific IgE are usually of little diagnostic significance. (3) Inappropriate data presentation. Presentation of data as “raw counts” has no scientific or clinical rationale, has not been shown to correlate with clinical reactivity and renders results more liable to misinterpretation.

Thanks for that info, Scott. I’m not sure if I will do the testing, but will post an update either way. Thanks again for all your help!

Quick update. :slight_smile:
Saw dr today. She gave me a low dose estrogen pill to take just before my cycle. Probably half or almost half of my migraines seem hormonal. If anyone knows anything about this form Of treatment, I would love to hear more. She said to try it for a month or two and see what happens.

She has referred me to a neuro who “specializes” in migraine. Hopeful!!

Have had little/no dizzies, even after two
Recent illnesses and lots of lying around. ?? Stopped doing VRT. lots of migraines lately. Therefore , lots of relpax.
Off to look up estrogen on this board.

Merry Christmas, all!! :slight_smile:

— Begin quote from "lovineachday"

Quick update. :slight_smile:
Have had little/no dizzies, even after two Recent illnesses and lots of lying around. ?? Stopped doing VRT. lots of migraines lately. Therefore , lots of relpax.

— End quote

It is said by some specialists that using triptans, such as your Relpax, for over 15 days a month can actually cause headaches. I don’t know how frequently this happens but it may be something to bear in mind as you seem to be taking a lot of them.

-Wexan

Given the fact that this did not start with a big vertigo episode lasting a few days, I think you never had VN. Given your symptoms and history of migraine, I think everything is migraine related.