Recurrence of attack

I was diagnosed with VM in January. A previous doctor thought I had Meniere’s. I have been following the Heal your Headache diet and taking magnesium and Migravent. I have been symptom free and without an attack for nearly 3 months. On Friday I had a vertigo attack without the spinning, but with all the other characteristics, sweating, prolonged vomiting, light sensitivity, ending with chills and shivering. I can identify no trigger for this event. Is it typical for VM to have periods of remission? Should I expect more attacks in the near future? I was feeling so heartened and hopeful by my time of reprieve.

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Well, not really. VM & MAV are generally conditions which have continuous symptoms like imbalance, nausea, dizziness and tinnitus, punctuated by infrequent acute attacks which have fallout lasting 2-3 weeks. Sometimes you can also have migraines. However, there is usually no let-up in “baseline” symptoms, so I’d not call the quieter periods “remission” exactly because things can be pretty uncomfortable, almost constantly. Long-term it is possible to recover though, it appears (as I have mostly, but it took years - but let’s not get into my case here, you can read about it in my journal linked on my user card accessed by clicking my avatar).

I’d say, long-term especially, it would be very unusual to find a person with VM or MAV that has no symptoms between attacks unless they are years into their condition post a years-long chronic phase and are clearly in a recovery trajectory.

That said, chronic VM/MAV can start with a couple of attacks spread out over months with not much happening in between, then one day it hits you chronically when symptoms become constant (only to potentially die off years later).

Long term, Meniere’s is generally known to cause significant irreversible hearing loss. This doesn’t happen with VM/MAV although some mild hearing loss is not unusual (though we don’t know to what extent this is reversible). Then again, there are definitely people who’ve been diagnosed with Meniere’s who’ve had no hearing loss.

The main difference between VM/MAV and Menieres, other than my proposed pattern of symptoms here, is unclear and sometimes appears to me as ideological, lacking scientific certainty. Heck, you can be diagnosed wtih Meniere’s and still be suffering migraines. And it can be dependent on who you see: an ENT will probably more likely diagnose you with “Meniere’s syndrome” and a Neurologist, VM. That’s not a great state of affairs, but I think it’s fair to say, that’s where we are at.

For example, I could definitely consider my condition to have been a mild form of Meniere’s that hasn’t lead to much hearing loss … as much as I might find other explanations if I chose to interpret things a different way … (and that has also been reflected in the variance of diagnoses I’ve received from doctors …)

It goes without saying, that whilst we can talk around the subject here, we cannot diagnose. That must be the responsibility of a qualified physician.

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I guess I should not have said” no symptoms in between attacks” as the tinnitus is a constant I have learned to live with. A feeling of being slightly off balance is also constant. Now , 2 days after the attack, the headache continues. I have only Advil to treat it, but do not want to take anymore for fear of rebound headache. I return to the otolaryngologist in May so am on my own with this until then.

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sounds very like VM/MAV in that case, but points remain about whether this is ‘academic’.