Help with my Mums Condition

Specific Illnesses & Conditions VM/MAV
1

Hi All,

After searching for hours trying to figure out more about my mums condition I found this forum, was wondering if anyone could help identify if my mums got Migraine related vertigo, or if its Meniere’s disease.

She has had the condition for a few years now, seen ENT specialists, and is currently under a neurologist from the Meday Hospital, her symptons have recently changed, she used to get very severe vertigo attacks with vomiting and diarrhea, but after a episode it would stop for a while before returning, then things got more difficult when she started to have the attacks very often to almost one a day, after lots and lots tests her initial medication was Betahistine, and when the attacks got so regular the neurologist gave her Nortriptyline this helped in the beginning, the attacks stopped and so did the dizzyness, things were goin very well, and he kept telling my mum to up the dose of the medicine, she did upto a point, she also has a very weak digestive system gets acid reflux, and then the dizzyness came back, and the most upto date symptons are she gets drop attacks, where she will be doin whatever and the dizzyness will come on instantly at different times of the day, can’t really pin point any triggers apart from her acid condition, when her stomach is upset the dizzyness comes on much more easily and regular. The severe attacks have stopped and this seems a new type of dizzyness, and it seems to be in the background but lasts pretty much all day

Im just needinig more help regarding what direction to take this, not sure if goin back to the ent specialist, or to get her to up the dose of the Nortriptyline or to start all over again with a different approach.

Mums 66 pretty weak and has a vegetarian diet…Any help and advice would be highly appreciated…

2

HI
I’m sorry to hear of your Mum’s condition. It sounds like the doctor put her on a good medicine in the nortriptyline…what dose is she on? A lot of time the body can get used to a med, and you have to increase the dose. I would recommend her trying phenergan as well, as it is prescribed for vertigo. I take it and have no side effects, other than sleep…but I take it at night.
Best of luck to you and your Mum…
Kelley

3

Hi, I’m sorry to hear about your mother’s dizziness problems. Personally, like your mother, I found my symptoms changed over time, although I wasnt unlucky enough to have the drop attacks. I was wondering if you should get your mother a second opinion from another consultant or hospital? As it’s been a few years since the start, it may be that understanding of these conditions has moved on a little since then?

4

hi firstly it great your trying to understand your mums condition as vertigo is terrible and can be isolating. from what i know drop attacks can be classic menieres, does your mum have tinitus?high pitched or low pitched if so?does she have any headaches?these are important questions as they can give clues as to whats going on. i would get some vestibular testing if you havent already recently. its possible something has changed or developed. i would get her on low salt diet as it may help if its menieres.
this is a paticulary hard condition to treat and diagnose so if she can afford it its probably worth getting the ent to check her but keep seeing the neuro too. make sure blood pressure etc is ok and she needs to get the acid under control as that can cause probs too.

5

Hi, Thanks everyone for the suggestions.

Mum started with 10mg of Nortriptyline and then the doc recommended goin upto 20mg and then as far as 30mg, but she never went past 10mg and sometimes 20mg cause of the constipation and also being to scared to take so many medicines, and also having difficulty diegesting all this.

It all started with Tinnitus, she has it real bad in one ear, and the other is slowly starting to get the noise in it to, she has a permanent hearing aid in the ear that is badly affected, and the other she also has one for but doesn’t use it all the time, her hearing is quite impared.

She doesn’t get headaches, just dizzyness, the first ENT guy she met said it could be a case of menieres, but the neurologist thinks its migrane related vertigo, however one thing I myself and she has noticed on many many occasions, if her stomach or digestive system is upset the dizzyness comes on much quicker and sometimes as a result of the acid, there have been cases when she has had a acid build up and will get dizzy, and upon taking some digestive remedy the dizzyness will almost stop. She is currently on a dose of Pantraprozole for her acid reflux along with some other off the counter medicines, but we can’t seem to find the triggers, the dizzyness is so spontaneous throughout the day.

She has had all the various scans, the last one she had was a MRI scan about a year ago now, since then regular blood pressure checks with doc and at home, regular visit to the doc, but he now seems to be becoming a bit useless!

6

i think your answer is get the stomach acid under control with a gp/dr, if vertigo goes then you know is related, if not you know you need to keep searching. It can definately fall into menieres or mav. Menieres causes more low toned ringing and can cause deafness… Mav usually has headache present or a history of headache/migrane or it can be silent migrane, higher pitched ringing too. Both can occour or have symptoms overlapping and thats the difficulty. I did read about acid and vertigo on a medical site so search around but stick to medically researched sites, if i find it ill email you. Has she always had acid is it new and coincided with vertigo??

7

I recommend some supplements in addition to her meds to help. Namely ginger as this will help with the stomach issues and can help with vertigo and magnesium citrate for the migraine/dizziness.

She should still try to get up on the Nortriptyline. I was bad on the drug until I got 4 weeks at 30mg under my belt and now I’m about to go up to 50mg and am significantly better.

Tests I would advise are the ENG tests to establish vestibular function. In addition if she is suffering anxiety with this (as most of us are) a low dose Benzodiazepine of either Valium (diazepam) or Rivotril/Klonopin (clonazepam).

Diet should be to avoid the 6 C’s:

Chinese food (because of all the MSG)
Chianti (wine/beer)
Cheese
Citrus
Chocolate
Caffiene

Read the book Heal Your Headache.

Please keep us posted.

8

Hi everyone,

Just thought Id update this as the info might be of some help to someone else to, mums had a few good months mostly due to medication more directed towards her stomach, in her last meeting with the neurologist he said that she now has light headedness and that the migraine related vertigo issues seemed to be less, however last year from around sep til christmas her dizzyness was still very persistant with a few severe vertigo attacks, but again everytime she has such episodes her stomach is always bad and soon as her stomach seattles her dizzyness slows down or stops, when I say her stomach is bad I mean full of acid so lots of releasing wind and burps continuously.

She was in India for a good few months last year and it was out there that on the off chance she went to a chemist to buy some remedy for digestion and was given a gaviscon type medicine (mum doesn’t take gaviscon as she says it gives her headaches) called Gestid MPS made by company called Ranbaxy in India, this seems to be helping her stomach and that in return seems to be controlling the dizzyness and vertigo attackts so far, she is still on the Nortrptyline but is taking 10mg once a night, further to that she is now given a high choestrol medicine as that seems to be rising slightly but this is due to her age/cultural diet, and she is also still taking pantaprozole. Im not saying this is the medicine that will work but its helping my mum so far, and my mum is very picky on the medicines she has, and the fall of it is, the medicine is not available over here in the UK, so we have family over there sending supplies over.

Just also to add that my mums condition seems to be highly linked to her stomach, not sure why this is, but it always been the case, everytime her dizzyness is kicking in her stomach is not right, further to that she still gets tinnitus in the ears and she is partly deaf in one ear, and the ringing is now starting in the unaffected ear also.

To investigate this further she met a gastrologist week or so ago, and he has now put her forward for a gastroscopy and we will have to see what he can suggest further to resolve her digestive issues.

I shall try to keep this updated on her condition, and a big thanks for all the advice given.

9

Hi -

I’ve recently developed an acid reflux problem, but not the typical kind that features “heartburn” (the classic symptom). It’s what’s called “silent reflux” (our symptoms are somewhat different) and I came across an article that said it was one of the surprising reasons that one may wake up tired. Not getting a good night’s sleep is a well known migraine trigger, and while my dizziness has been well controlled, I’ve had an uptick in headaches lately…

Anyway, here’s an excerpt from that article, in case it might be of help in your mother’s situation:

"Recent sleep studies have shown that up to 25 percent of people who report sleeping poorly without a diagnosed cause have sleep-related acid reflux. But because they don’t have obvious heartburn symptoms, they’re unaware of the condition.

How it interrupts sleep: Acid reflux causes the body to partially awaken from sleep, even when there are no symptoms of heartburn. The result of this “silent reflux” is fitful, uneven sleep, but when you wake up digestion is complete and you can’t tell why you slept poorly.

What to do: Follow treatment suggestions for heartburn, even though you aren’t experiencing classic heartburn symptoms: Don’t eat for at least two hours before hitting the sack, and avoid acid-causing foods in your evening meals. (Alcohol, chocolate, heavy sauces, fatty meats, spicy foods, citrus fruits, and tomatoes all contribute to heartburn and acid reflux.)

Sleep studies have shown that sleeping on the left side reduces symptoms, and sleeping on the right side causes them to worsen because acid takes longer to clear out of the esophagus when you’re on your right side. If you prefer to sleep on your back – a position that can increase reflux – elevating your head and shoulders can help.

Losing weight can do wonders to banish heartburn and acid reflux."

I’m using a bed wedge pillow, I’ve lost weight (still working on that), and I’ve changed my diet. But I still wake up some mornings and don’t feel rested. I’m on my third medication for reflux, and I’m going to try getting glasses with the special tint that they do at the Moran Eye Center in Utah for the headaches. Best of luck to your Mom!