How to tell the difference between MAV and labs


I’m having a real hard time getting a diagnosis from my doc (neuro-oto) about what exactly I have.

12 years ago I had a bad vertigo attack that lasted for 2 or 3 days. Room was spinning, throwing up, etc. After 2 or 3 days I could get out of bed and get around but ever since I’ve had the following symptoms 24x7:
brain fog
cognitive issues
ear fullness

I have not had another vertigo attack. My doc says I don’t have Menieres because my symptoms are not episodic. My mother has migraines, so I would lean toward that. My doc keeps thinking it is some kind of virus attack in my inner ear 12 years ago that did some damage. He has me taking anti virals and Vitamin B shots but I’m not very optimistic. I’ve been to countless doctors of all types and none are of any use. My MRI is clean. I’ve tried Verapamil for 3 months (got up to 320mg/day) but it didn’t help (I am also following a migraine diet). I’m also trying nortitrpltyline (I am 40mg/day and have been taking it for about 3 months-at 30mg/day dose)

The way I look at it, it’s got to be either MAV or uncompensated labs. How can I figure out which one it is?

-Utterly confused.

I was dx with MAV because all my vestibular testing was negative. Did you have vestibular test (ENG, etc)? That helps to dx by seeing if there is damage to your vestibular system which points to an inner ear disturbance


The best way to determine MAV is in part the symptoms wich you match, ruling out other things, then looking at past history both personal and family.

Do migraines run in the family? Motion sickness? In the family, long car rides, carnival rides, etc.

For example, my sister and grandma get migraines, I have always had a problem with migraines and headaches, several of my cousins and myself get nasues during long car rides, and I have never been able to do a series of summer saults in a straight line or without feeling the contents of my stomach.

Yes, my mother has migraines, my brother has ear problems (dizziness) that he says are helped by having tubes in his ears. I’ve always gotten car sick since I was a kid. I always had to sit in the front seat or I’d get very sick. I’m thinking MAV but I’m pursuing this from both perpsecitves-mav and labs. My doc is always unwilling to offer a specific dx. very frustrating.

It might be uncomfortable, but in your case, the best thing you can do is have an ENG test in my opinion It will make you dizzy as hell, but you’ll recover from the test. If you can get through the test, it will show weather your inner ear function has suffered or weather you had labs and then migraine took over. I’ll be honest, it sounds like you didn’t compensate from the labs because you didn’t have a single break of clarity between the labs and these symptoms. I had the same problem as you, however, I had 8 months of normalcy before I got hit with the MAV so I KNOW that there was no inner ear play. You went straight from 2-3 days of spinning to 24/7 suffering and although I am not suggesting there could be no MAV there, I DO think it would be prudent to take vestibular damage out of the equation by getting the ENG test done. If it’s normal, you have MAV most likely. If it’s abnormal, you most likley have uncompansated Labs and would benefit from vestibular therapy and would probably recover just from that. That’s my opinion.


Thanks for all the advice. I see my neuro-oto next month and will ask him more about all of this. He is very elusive about committing to a dx.

I just spoke with my doc’s new partner and he said my official dx is something something polyneuritis. Have you of you ever heard of this? He said my ENG is abnormal and my hearing tests are normal (no hearing loss). He said VRT would probably help and that I should continue to take the antiviral they prescribed to me and also I’m to do vitamin deficiency testing this week.

Is this data consistent with any of your experiences?


Basically, by saying that you have polyneuritis, they are saying that your balance nerves are inflamed, and causing you to experience typical symptoms. If that’s true, you DON’T have MAV. I had a feeling that it was something inner ear from what you were saying, as you seemed to have no break from the labs to the “new condition”. The VRT will help, and the steroid will help to lower the inflammation. It may take a while but you will get through this. Believe it or not, MAV is a MUCH worse condition to have because the brain does not compensate as easily as the inner ear for balance problems. A few months on the therapy and you should be right as rain