That’s going too far. Dogmatic assumption that migraine is the cause.
Perhaps his Hydrops was giving him headaches and Propranolol somehow alleviates the physiology of Hydrops in some way.
Given we don’t know why propranolol helps from a molecular/physiological perspective, you simply can’t make the assumption that migraine was the cause.
These drugs are labelled rather coarsly as ‘migraine prophylaxis’ … yet we don’t know the physiology of action of each of the sub-classes of drugs … its just an epidemiological relationship … they could easily be fixing an issue which then reduces the likelihood of escalation to significant neurological issues.
Maybe the propranolol is helping to reduce the extent of or the impact of the hydrops in some way? This in turn helps alleviate the knock on effects?
Also, it annoys me that we then get no explanation as to the possible cause of the migraine? ‘Migraine’ is not an explanation. It’s part of the complex of issues.
In any case, it’s a fantastic clinical result, more power him!
Its not just propranolol that works, all migraine meds do , more than a coincidence.
In the absense of migraine and trauma, what caused the hydrops.[ provided there is even an hydrops]
The doc who made this video is the expert who presented at the migraine summit. Not some snake oil salesman but a guy who devoted his life to years of research in this area.
Absolutely, agree that’s also a very good question.
So in conclusion, what is the ultimate cause of this ear issue/headache combo?
You are alright with magical hydrops ? No rhyme or reason sudden hydrops in the absense of trauma.
But a migraine which goes from episodic to chronic slowly is unfathomable as a causation mechanism .
Definitely not OK with magical hydrops at all. It’s an absolute travesty we have no explanation for idiopathic Menieres (or idiopathic MAV for that matter).
I guess we just have to wait for science to make even more progress.
I’m nitpicking but dogma can hold back science.
Obviously this doctor did absolutely the right thing to try this out and both doctor and patient were rewarded with improvements.
To prove migraine as a causation for chronic dizziness i need one real life example of recovery. I have 1000s who have become 100% on prophylactic medication.
You are saying migraine cannot cause dizziness, how are so sure that is true for every one on this site ? You say everyone has hydrops , how can one theory work for everyone? There is no science to back up your hydrops theory in absense of trauma.
The workflow for trauma to ear cannot be the same as that for idiopathic causes. The fallacy is assuming both of them have the same end result(hydrops)
If everyone had hydrops why does the same propranolol NOT work for everyone?
That’s not proof of any cause… that’s just an epidemiological result … its just saying the treatment is successful. No doubt it helps a lot! Would never argue with that.
Another possibility is they have some irreversible change that’s occured but the result of that can be managed with this treatment. But what was that change? I’m not satisfied with calling that change ‘migraine’. There’s surely a deeper explanation.
(And btw your statistic doesn’t seem very typical of the experience on mvertigo? But I digress.)
Perfectly reasonable question. I would ask why propranolol doesn’t work for everyone regardless of considerations of things like hydrops? Why doesn’t every migraine sufferer improve with propranolol?
I’m not claiming everyone on this site has hydrops. We were just discussing this particular case.
I do believe that most people on here are suffering from sensory instability for some reason and who knows if there’s a vicious cycle in MAV (mentioned this before).
I have suffered with this crap for 3 years. My trajectory of this illness does not support leave this alone and you will get better. I am adult enough to know the difference between a “vestibular ear attack” and a “migraine attack”. My jounal has the level of detail that i can tell my prodrome and postdrome. I know what i have, because i experience it daily and i am well read.
You are doing what you need to do, I respect that. And you follow the advised treatment protocols. That is absolutely right.
But that’s a slightly different discussion than actually getting to the molecular science, because the treatment protocols are running ahead of the detail because they are the easiest thing to test and evaluate.
There is no molecular science in your theory than the fact it resonated with your experience of the illness.
My experience of this illness tells me otherwise.
There’s no molecular science full stop.
Sure, everyone’s experience affects their opinion, no doubt.
Well Vignesh thanks for posting this video. As a person who takes Propranolol the only thing that surprised me was that it helped a person diagnosed with Menieres rather than MAV. In terms of the speed in which it worked - to stop acute vertigo attacks - I’m not a bit surprised. Exactly the same happened with me. I wanted to shout loud enough for the doctor in question to hear me. It stopped my acute protracted vertigo attacks completely for three years and three months from the day I swallowed the first Propranolol pill. I was almost at the point I could say ‘for good’ when I had one full on attack in January of this year. Now whether one considers my acute vertigo attacks as ‘migraine’ or anything else scientifically (no lop-sided headaches for me) is immaterial to me as is what causes ‘migraine’ in the first place, not that I don’t think it’s a valid question worthy of some considerable research. Personally I think it’s a bit too idealistic to expect to get an answer to that question any time soon but I have no trouble accepting that my own ‘vertigo attacks’ are my own body’s version of say your ‘migraine’ attacks and perhaps the fact Propranolol worked so well on them kind of proves that. I’m just grateful it did, and still helps me immensely. I‘ve found it a very kind drug and I don’t recall it getting any adverse publicity on here.
Presumably because there are various different root causes. The man in the video with hearing loss and ear damaged Menieres improved, I improved and I don’t have ear loss/damage (hormones are my chief suspect). Again it would be being too much of an idealist to think life could be that simple but, just perhaps everybody would improve with propranolol if everybody could tolerate it at a sufficiently high enough dose for sufficiently long enough because, although it can work quickly to stop acute attacks, it can take ages to help with other symptoms like eight months to stop my 24/7 dizziness. And people generally just aren’t that patient. Helen
I have fluctuating hearing loss in both my ears(left ear being particularly bad), i wonder if its because of my permanent dizziness that my brain is compensating for, or is it because important nerves are fried due to my autoimmune diseases?
Exactly my sentiment too. I am not holding my breadth for answers.
I also think the scientific community has made significant progress where they are able to show the vestibular ganglion activity in the case of Vestibular migraine. They also have ear images to show inflammation during migraine. I have posted papers on this in the past and i will continue to monitor the VM advancements but i doubt it will make any significant changes to my treatment protocol.
On a different note does Propranolol cause weight gain ?
Not only can propranolol cause weight gain, it can also cause type 2 diabetes. It can also worsen existing diabetes.
Good to know
It could be migraine causing fluctuating hearing loss. Has the meds helped you ? What frequency fluctuates?
I have low frequency hearing loss, and abnormal caloric tests. Neurotologist said the balancing nerve in my left ear does not function properly which causes my dizziness.
I don’t believe that I have migraines, because no migraine meds have ever helped me, I have tried amitriptyline, propranolol, many SSRIs, ergotamine, sumatriptans etc etc.
I no longer get any headaches but the crippling dizziness continues. Only two classes of med helps me- benzodiazepines and a few antihistamines(diphenhydramine,chlorpheniramine etc)
I strongly suspect that I have nerve damage.
If it is a stable damage you should have compensated by now. Does Meclizine help you ?