Originally Posted by Ciegr2

It seems that so many physicians simply perform a battery of vestibular tests (optokinetic drum tests, caloric irrigations, pursuit and saccadic testing, etc.) and inform the patient that the vestibular system is working properly. In fact, most of the time they are correct and your vestibular sensory organs in your ear are sending messages normally to your brain. The problem there in lies in the way the brain receives the signals and direct your body to compensate for them. Rather than thinking about it pathology in the vestibular system producing dizziness why not think about all the things that must work properly for an individual to feel stable. For instance, you must have a stable heart that beats normally without arrhythmia or valvular dysfunction to deliver maximum blood to the brain. You also need to be free of organic disease in the brain (vascular abnormalities such as arteriovenous malformation, multiple sclerosis, tumors/cancer), you must have appropriate visual integration from your eyes and brain, you need proprioception to the spinal column from the neurological receptors of your body to tell your brain where you are in space, you need normal glucose concentrations in your blood, you need normal oxygen carrying capacity at the cellular level, healthy lungs, etc. Of course the most common cause of dizziness is medication!! Many people need neurological retraining of the central nervous system that an increase in medication does not address. It is ridiculously common for Mass Eye and Ear to dx you with Migraine associated vertigo but unfortunately their diagnosis is one of elimination rather than critical evaluation. What’s even more ironic is that the testing that they performed most likely held the key to understanding and treating your disorder but unfortunately there was no physician available to observe and understand your reaction to the tests in real time. The tests were done by a tech with no understanding of the integration of the intricate vestibular and other central nervous systems. You simply went upstairs where the “specialist” who looked at some ink on a paper and decided that the trace recordings were not indicative of vestibular disease. What a shame! Perhaps the tests were not equal in activity from side to side, perhaps there were subtle overshoots of your eyes, perhaps you pursuits were asymmetrical? In fact they may have all been within normal limits but not equal leaving you ill equipped to deal with your environment. What tests were performed to reach the diagnosis of migraine? Of course, none. You were sent home like countless others to take more meds. What is the method of action of the meds? Most likely meclizine which is glorified valium that actually is a depressant to the vestibular system. Seems a shame to take more drugs to numb your vestibular system when it is not the problem doesn’t it? In fact if you are ever going to recover and teach your brain to cope, do you think that depressing your healthy vestibular system makes sense?