Hello all.

I wanted to ask a question about MAV since, I'm in a long decomp, or what seems like it, with a huge case of allergies, and throat soreness and infection, wich I'ce only managed to control for some weeks but haven't been able to get rid of them.

All my life this has been my nemesis, and I blame it as the main cause of my vetibulopathy.

Anyway as I'm collecting data for my nest neuroto appoinment, having this and MAV as my second suspect for this 7 month "decomp", where I 've only got 5 days completely vertigo free around two moths back, and even on those days I still got some flu, wich has not abandoned me all year, so I came to suspect on MAV, since on those day I "locked" out of the blue to a 100% with no significant change on my routine or my general helth state...

Checking this in here, and due to my prior Migraine history, I came to suspect of MAV, since in this recent relapse(three weeks now), I almost came to feel exactly like back in January when It all started...

I've been on VRT, and trying to get my allergies under control, but my suspicious on MAV got bigger when two weeks ago I've got a MIgraine like attack, quite milder, but clearly a vascular type headache, with most of the uneasiness associated to Migraine.

And since my recovery doesn't seem to be exactly related with time, since now I feel almost like at the begining, opposite to an avrage case of VN, I think I xould be dealing with MAV somehow.

Obviously I'd like to check this with my doctors before starting any MAV related treatment, so finally my question is:

A most of VN and MAV symptoms mix, I'd like to ask if it's common in MAV to expeerience visual trouble, aside from the auras and scotomas, like oscillating vision, jumpy and or vibrating vision, wich has been one of my main troubles this year..., and if it's also common on MAV burst of spinning like vertigo, and droping and swaying sensations...

I know I do have a vestibular dysfunction in my right ear, because of the results that came out from the caloric test, but with all test combined, my % of compensation showed taht the injury was old, and for my neuroto I shoud be almost vertigo free in three or four months, since as she said "we couldn't get you dizzy at all in the tests".

But as my case has evolved, when I got an "attack" or when vertigo gets "connected" as I call it, even the slightest motion, visual stuff, and even temperature changes can give me hell, sometimes even sitting down.

And this stands true for my VRT exercises which pass from a non existent vertigo or dizziness even with the toughest ones, whe nvertigo is not "connected" to a "I'm going to fall" sensation with even the mildest ones, when my vertigo is "on"

I don't know if this is common both to VN/Labs and to MAV aswell.

I've been also checked in audiometry and ear pressure for Meniere's, and they ruled that out, because besides my dizziness chronic nature, and the usual vestibular diseases' shared symptoms, I don't have the usual Meniere's symptom profile.

So, this leaves only(I thinK) MAV as the most probable cause for my chronic, unstabe. not yet controled, and not yet improved condition. But until I don't get a confirmation on this I'm just guessing, so that's why I wanted to ask you about this.

Thanks in advance.

Hi Stargrave,

Looks like we might be in a similar boat with this thing. And given your migraine history I'd say MAV is highly suspect indeed. Like you I've been in a chronic sort of decomp now since arriving in Europe. It was kicked off at the time by what I thought was an increase in exercise but I now think the intense hayfever that struck on my arrival (i've had grass allergies most of my life - proven by testing) and the reduction of the SSRI was probably the reason. The possibility I am thinking about now is that the low dose SSRI is probably not enough to keep the migraine syndrome switched off completely. Rather, 10 mg of Cipramil probably keeps my head *just* above water although the odd wave washes over me and brings on symptoms for hours or days. There's no question that as my tolerance increases (with meds only so far) I am less likely to feel off by regular events. I even tolerate LCD screens much better. But bring on the decomp and it can be like month 3 all over again for me.

Even though I am thinking the SSRI keeps my head above water I may try and reduce it further to see if this is in fact true. My doc seems to think that 10 mg of Cip is not therapeutic at all but I don't believe it. If I can stay as I am now on an even lower dose than great. I still have weight gain hassles from this med which drives me mad.

Anyway, I'll be keen to hear what happens at your next neuro appt and if you do indeed respond to migraine treatment.

Have you checked out all the MAV info at Timothy Hain's website? Some good brief info there.

Cheers....Scott :cool:

Hey,

You will find a lot of docs spout that rubbish about anti-depressants and other meds in migraine - a psych i dealt with tried to convince me 10mg of amitryptiline has no benefit whatsoever. :rolleyes:

It seems doses as low as 80mg for Verapamil, 10mg for amitryptiline, 20mg for propranolol - and many other examples - are therapeutic for migraine when they would make little difference for treating their primary purpose (hypertension for Verapamil, propranolol and depression for amitryptiline).

As you said - you just need to keep below that threshold - of whatever it is that causes the problem (neuronal hyperexcitability is definitely a part of it, could be ion channel dysfunction also). The book 'Heal your headache' that gets mentioned so often has a good description/diagram explaining the idea of keeping below the 'migraine thereshold' and how reducing food triggers, stress, and taking medication are likely to each play some part in doing this.

Adam

Hey! thanks for the replies.

Yes Scott, I already got a look to Dr. Hain's page, and here is my new little loong reply and case exposure for everyone to read and give an opinion.

Increasing my suspicion on MAV, in all of my tests, even in some acute phase, no spontaneous nystagmus appeared, not even in the numerous Dix-Hallpike manouvers performed on me, just the mild difference between both ear's response found in the caloric test.

Besides much of the fogginess, and "odd" feeling was no new to me, and here is anoher suspicion for MAV, as I recalled recently, some years ago, about ten or a little bit more, I started to have this "dizzy" eposodes, not with an exact unbalance, or spinning, bunt much more with the fogginess, like having cotton in my head kind of stuff, light sensitivity(both this and sound sensitivity are things I've experienced for years), and this general spaced put feeling, with no head ache.

For some reason I blame this to a mild rise in my blood pressure, It was never really too high, wich now thinking could have been stress related, they gave me a quarter of a pill of a beta blocker, not sure if it was propanolol, and, combining this with exercise, the feeling eventually went away...

It may be a coincidence, but, without being an exact Migraine treatment, exercise, a beta blocker, and a change in diet targeting blood pressure(low caffeine, salt, etc.), It actually was a migraine like treatment so... more suspicion here.

So that's why much of the symptoms of this year's episode, weren't exactly new to me, because I even got some constant "pulling down" sensations back then(like when you get out from an elevator), and some odd visual sensations with tunnels, changing lights or visually busy environments(visual dependency like), wich I never related neither to Migraine(because of not having any headaches), or Inner Ear, wich never even got through my mind then.

What was entirely new for me is the spinning(my "official" inner ear stuff started with a BPPV like attack on 2004), and this year's visual trouble(involving images jumping or oscillating), the general unbalance and swaying feeling(like being standing or sitting in a moving pole), and some quick bursts of one of them or some them combined.(this cocktail of symptoms is from what I wanted to escape all year long)

So basically my case is:

1. Migraine History with prior MAV like episode ten-fifteen years ago, never considered, tested or mentioned, but curiously treated like one, with good results.

2. BPPV like attack on Nov 2004(positional spinning vertigo), where I was only tested(negatve as usual) by an ENT with a Dix-Hallpike manouver, given the Cooksey Exercises as VRT, recovering with them combined with exercise in 5 months or so, great through the year(moslty 100% in 2005) with only one mild mid-year relapse(Dix Hallpike Negative again), more VN suspicion Dx(bye ENT again), with no further tests to check it out.

3. My current and new vestibular episode, wich started almost seven months ago with some kind of positional dizziness, not as strong as in 2004 but lasting longer, much like motion sickness, prior to almost two months wih cold-throat and allergies trouble. This evolved twith some other new symptoms added like the visual trouble and unbalance, wich lead me to the neurotologyst(and to this board) appointment where I took all the tests available, with the exception of an MRI and the Rotational Chair, and they found an "old"(as they described it) vestibular dysfunction in my right ear, wich, given the degree of compensation showed in the tests, shouldn't give me much trouble with some VRT(Cooksey exercises again) after three months or so.

The truth is that I'm still in trouble, up to the point that I returned to an "emergency check" after an awful day, where they tested me for ear pressure, and saw that both of my ears were sore due to my allergies trouble, blaming this for the episode, and giving me treatment and tests for sinusitis(negative), and up to date I still can't control them at full, so... there is supsect #1 for the doctors, and I agree with them BUT....:

1. I've experienced a full year with months feeling at 100%(2005), after to what seemed to be my initial "real"(inner ear related) vestibular injury in Nov 2004, even with a similar allergy-cold perennial condition all year, wich has been a chronic stuff through years for me.

2. I my actual dizzy/cold/allergie/unsteady condition, I've managed to get five days exactly this year, at a strong 100%, with no significant change in medications, general healt condition, or my VRT routine.

3. My actual state of dizziness feels like a connected/disconnected process, where I can fell as low as a 60-70% and as up as a 90-97% without a noticeable, gradually immproved condition of recovery. Meaning that, opposite of what they told me, one day I can be dizzy free just like that, and the other I'm back at dizzyland, with no strong evidence of an overall, permanent improvement whatsoever.

So that's why MAV is my # 2 suspect, and I'd like to adress this issue on my next nuroto appoinment, wich I'm holding for a while until my allergies get to a reasonable controlled point, where either I get back to this 100%(wich I doubt a little), or the doctros can discard them as the main reason for my failure to compensate for my vestibular injury, and give some thought on MAV to treat it, if it's the case, helping me for a definitive recovery on this. Unless, of course it could be somehting ellse, but I couldn't imagine what.

P.S.

As what it seems a common ground for this stuff, without being diagnosed with TMJ, I've developed some jaw stiffness and pain, aswell as some neck stifness and pain(I think all stress related), wich of course play their own negative game in my case, so I'm trying to get rid of them or rule them out too. ;)