Visual Vertigo

Just spotted this case in a Nick Silver presentation. This young lady took Prothiaden which completely cleared up her visual vertigo. See the bottom of the slide. So, it seems clear that treatment can stop this lousy effect.

Scott

Gosh, she was on such a low dose as well. If only …

Christine

Hey Scott,
Interesting find. I’m on Maxalt and Valium now. If I don’t get relief, I’ll ask my doctor for Dosulepin and see how it goes. Thanks for the info

Six,
I"m not certain, but I believe that med isn’t available in the US?
Lucky lady that she got clear of this mess so fast and with a low dose med…
Kelley

Other than the weight gain and loss of libido Prothiaden has been brilliant for me too. 95% wellness.

Hi I’m on Prothiaden and most of the visual symptoms have stopped.
75 mg, yes libido sucks.

I would say I’m doing about 50% better on it.
still migraining once a day though.
used to be twice a day.

Fluoro tv screens and comps used to trigger me too.
Forgot to say, Effexor did help with the visaul stuff also, but it made me FAT and lazy. :shock:

jen

Jen,

Which drug rid you of the fluoro + computer screen symptoms? I am about to turn guinny pig next week and want to have a list of possible drugs to try. Right now I have propranolol, pizotifen and efexor on my list. Thanks!

Craig

Hey Craig,

Check out this link

healthboards.com/boards/show … p?t=240520

Looks like a few found Lexapro helped with VV. Let me know what you end up with. I’m really interested in getting something to help my eyes when I’m on the computer. It’s still very uncomfortable for me.

Hi Craig
Prothiaden
Zoloft
Effexor

We are all different sadly. It doesn’t mean that it will work for you.
I’ve tried so many things others have said worked only find they made me sicker, it’s just the way it is.
As you’ve prob read, most meds will only calm the symptoms down “dampen them” for some, for me that’s about all I’ve achieved on meds.
I do use valium as a sleeping aid, and for when a Big attack happens or special events.

Jen
Wishing you all the best.

Thanks for the information, everyone! So glad I found this place.

Just a quick question. What does the acronym “SSRI” stand for? I am assuming it’s seratonin reuptake inhibitor, but not sure.

Craig,
Selective Serotonin Reuptake Inhibitor…
As the class of meds had advanced, they get more selective about which neurotransmitters they hit…Lexapro is supposedly the most selective. Whatever that means! That’s what my doctor told me.

Six,
Lexapro might be a good one for you to try? It supposedly has less side effects for most people…for me it wasn’t too good, but neither was Fex…I seem to do better on meds that hit both sero and NE…

Good luck!
Kelley

Kelley – a highly selective drug means that it binds a receptor very well and does not hit anything else. I haven’t seen the data for Lexapro in this regard but I’d say it does not interact with anything else but the serotonin reuptake port.

http://www.ssrireview.com/images/products/ssridiagram.JPG

Lots of wonderful information here!

With regards to MAV, what I don’t understand is how “migrane” may be responsible for triggering the visual symptoms that I have. I find it difficult to believe that I have had a 6 year, non-stop migrane. Do any of you have “headache” that accompanies your VV? I know that “headache” and “migane” are not the same. Personally, I do not have “headache” with my VV (although I often get them as a by-product of really bad days).

Does serotonin have a direct connection with “migrane”?

Craig
You have to stop thinking of migraine as a headache…I used to do the same thing and thought my neuro bonkers for even suggesting Migraine for my dizziness. In my opinion, I just think of it as hyperexciteabilitiy in the brain that affects how we respond to certain stimuli…some people it’s lighting, others it’s smells, others it the sensory/balance of their surroundings…others it’s food/additives etc…for many, it’s all of the above.
I think my brain got locked into a new “normal” where it thinks it’s supposed to be like this now, and I’ve had to resort to certain medications to help calm my brain down from this over excitement…
That’s my own two cents anyway.
As far as serotonin, it def has it’s role in migraine, but I think other things can be at fault as well…I’m looking into Glutamate, which is the main exciteatory neurotransmitter in our bodies…the drugs that abort an acute migraine affect serotonin…they are the triptans. I don’t know much about them as I never get those kinds of headaches.

Kelley

So I have an appointment with my GP on Tuesday. Which meds/combos would anyone consIder starting with? Remember, I have already tried amytriptyline and topomax with no results. Having a really bad time of it lately and am at wits end with this. 6 years + no diagnosis and I feel totally defeated. Thanks for any input.

Beta blockers seem less popular as a med than others on this forum but I’ve had good results on them - you do need to allow at least 3 months for them to really kick in though - in the meantime maybe some benzos would help tide you over?

good luck!

Hi everyone. I am having the exact same problems as a lot of you describe in this thread. I sit in front of the computer for 8 hours each work day – and after 20 min it gets worse and worse. And when I get up to walk about it feels like my head is going to explode. I also have trouble in stores. As soon as I get outside it all becomes a lot easier. I have tried almost anything to fix the computer problem but no luck yet. On weekends I feel much much better. The unbalance completely goes away when I am driving or swimming. I’m at the end of trying Nortriptyline, which has taken the top off the dizziness. I love my job as a graphic designer – so I am hoping to find a good drug soon…

Well, I have been learning yet again this past week just how badly visual vertigo can really do a number on me. I want to tell this story to know if others can relate and it may help you to realise that you are not going nuts. So here’s what’s been going on:

The week before last, I went through two fairly tough interviews. It’s really the first time in my life I’ve been raked over the coals like this by a group of professionals so I had to be firing on all 8 cyclinders, prepare, and concentrate like crazy for 2 solid hours. The process jacked me up of course as you might expect but I was relieved when it was over. Then this past week I was offered both jobs. Brilliant news of course and I had a big rush of excitement and anxiety too over resigning my current position and not wanting to leave them in the sh*t. All week while this was happening I was of course working away on my computer noticing that my vision has been a little bit more wonky. By Thursday, I was really feeling anxious with all of the change that was occurring and likely some fallout from the interviews etc. But what I wasn’t aware of and thinking I was going mad was that by the end of each day I started having really stupid irrational fears going on in my head about the new position and not being able to measure up – performance anxiety basically. But I couldn’t stop it no matter what I did. It was really way, way out of proportion and totally stupid.

This morning (Saturday) I woke feeling the worst I have been in a long while. I went to the GP around the corner because I cannot keep going on like this. She gave me a script for valium (said to knock back 5 mg every night for 2 weeks) and up the Paxil to a minimum of 10 mg (I’m on 2.5). I’ll go with 5 for now and see what happens.

Anyway, I’ve been off the Mac most of the day just checking in here and there and guess what? No more irrational stupid thinking!! It’s gone. POOF! What seems clear to me is that it plays out like this:

If visual vertigo (VV) is a problem for you then all it takes is a slight bit of normal anxiety or excitement to exacerbate the VV response. The more you feed the VV the more anxious we feel, and the more anxious you feel, the more it directly affects your thought processes. Thoughts affect physiology and physiology affects thoughts. This to me is a great relief that I’m not losing my mind per se and that it is just VV turning the screws.

I’m seeing a specialist on Tuesday and this is going to be my plan of attack. How do we get rid of this problem once and for all? I need these eyes of mine to stop making me feel anxious and to stop being so hypersensitive to environmental stimulation, especially computer screens. Basically it will boil down to drugs no doubt. I don’t know of any eye exercises that stops this really. Maybe I’m wrong. Perhaps I need to investigate some way of making my brain less visually dependent. Can anyone think of a specific sort of VRT that accomplishes this? Does it even work on a migraineur? Has anyone successfully reduced or eliminated VV without meds?

— Begin quote from ____

[size=130]Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety.[/size]
Simon et al. Annals of Clinical Psychiatry 1998.

Somatopsychic model: cases of panic disorder are triggered by misinterpreted internal stimuli (e.g. stimuli from vestibuar dysfunction), that are interpreted as signifying imminent physical danger. Heightened sensitivity to vestibular sensations leads to increased anxiety and, through conditioning, drives the development of panic disorder.

The vestibular system consists of inputs via vision, proprioceptive organs, and the vestibular organs of the ear, which input into the central vestibular system; the outputs are the vestibuloocular reflex, the vestibulospinal reflex, and autonomic activity.

— End quote

Scott 8)

Hi Scott

Glad you’ve worked out why you’ve been feeling so bad. And kudos to you for getting both jobs offered!

This concept of Visual Vertigo is interesting. I haven’t actually been given the name Visual Vertigo but I went to two VRT therapists and both said it wasn’t my balance per se that was faulty (I was in normal range on posturography test) but that my gaze stability was a bit poor. So the VRT mainly consisted of what they called Gaze Stability Exercises. I wasn’t very diligent at doing them though as they made me feel sick. Perhaps I’ll start them up again. They involved fixing my gaze on a credit card sized piece of paper stuck to a wall and moving my head in lateral and vertical planes. Others involved walking in a straight line while moving my head laterally and another one was reading the scrolling tickertape you get on some news channels while moving my head laterally.

My first otoneuro said this mismatch between visual info and balance is typical in MAV, i.e. our core balance is usually ok.

It MIGHT therefore be worth trying VRT for this.

I had assumed everyone who had VRT had gaze stability exercises but maybe I’m wrong. Has anyone here been told their actual core balance is impaired and thus had less visual VRT exercises?

Dizzy Izzy

Hi Dizzy Izzy,

Interesting info. Thanks for that. This is an interesting point you made from the neuro:

— Begin quote from ____

My first otoneuro said this mismatch between visual info and balance is typical in MAV, i.e. our core balance is usually ok.

— End quote

Though I have had some sort of vestibular insult (what appeared to be VN in 2003), nobody ever detected any vestibular deficit via the caloric or head impulse test. Still I have some other damage that is not explained by MAV such as the inability to play guitar without kicking off huge disorientation. Something got trashed in my brain but I have no idea what. But overall my core balance is fine. I think it always has been even though I’ve had enough dizzy episodes to sink a ship. The MAJOR issue has always been this mismatch between my eyes and vestibular system which can generate a ton of anxiety and dysequilibrium. Through all of this though I could easily walk along a plank of wood without dropping off.

I will ask the guy on Tuesday if he thinks I could gain anything with VRT. My experience with trying eye exercises is that the effect is worse when I’m symptomatic and not a whole lot of effect when in a good spell. Suggests it’s all MAV related to me.

Scott