Has anyone spoken to their doctors about a diagnosis of MAV? What is it?
Migraine is a problem where blood vessels in the head contract and relax abnormally. Depending on which blood vessels are acting up during a migraine event, different symptoms can occur. Headache is the most common migraine symptom, nausea and sensitivity to light are probably next on the list, followed by balance symptoms and visual aura.
Migraine Associated Vertigo is caused by poor blood circulation in the arteries in the head or to the blood supply that leads to the inner ears. It could be one or the other, or both areas involved that could cause balance symptoms.
This is the THIRD most common cause of vertiginous (having a sensation of whirling or falling: dizzy, giddy, lightheaded, reeling, woozy) symptoms. Can this restriction/poor blood flow cause permanent damage in any way?
Migraine patients are at slightly greater risk for stroke. There is some research data indicating that migraine can cause ear and eye damage. What causes it?
Sometimes a root cause is hard to determine. There is definitely a genetic component involved in migraine (for me, I have blood-relatives who also have some type of history involving vertigo). And migraine symptoms can be triggered by many things, including trauma, hormone levels, foods and barometric pressure changes. But causes are different for different people, and it’s more common to treat the condition than look for the real cause. An FYI that you may never know the reason you have them, or the reason why your symptoms get worse or feel better. What are the symptoms?
From a balance perspective: Balance symptoms vary, and a person with Migraine Associated Vertigo will usually end up having a myriad of unexplained balance/vertiginous sensations/symptoms which tend to multiply the longer you have this condition. Symptoms fluctuate in sensations and severity. Sometimes you may have them very severely and they will come on all of a sudden, and sometimes you may carry them on some level throughout your days and nights and can feel them starting to worsen or alleviate.
Symptoms can also include feelings of rocking/swaying, spinning, elevator feeling, and unsteady gait, to name a few. Usually some type of headache is present with symptoms, but not always. Symptoms can come and go, sometimes going away for months at a time. And, you may not have all symptoms, or you may have more than your share – it can vary. The primary symptom for women is an increase of symptoms during or around menstruation.
Migraine Associated Vertigo can also cause Benign Positional Vertigo (BPV, BPPV), so a person can have BVP on top of Migraine Associated Vertigo. How’s that for a double whammy?!
This also can lead to panic attacks and feelings of anxiety, which most people may experience due to their balance problem. How is a diagnosis formed?
The “usual” tests for dizziness (ENG) are given and other dizzy-causing conditions are looked for (sometimes through MRI or blood work, to name a few). Sometimes the Rotary Chair test is given, especially if other tests came back “normal” (I did not have this one test). Other “dizzy” conditions are ruled out - for example, diagnosing Benign Positional Vertigo is ‘easy’ due to the way the eyes move upon examination, an ENG will determine if the cause is (for example) labyrinthitis, an auto-immune illness of the inner ear usually results in rapidly progressive hearing loss (this was a specific question I had, as I was exposed to a virus infection in the late 1980’s), and so on.
If all tests come back stating “normal” then other factors are taken into consideration to make the diagnosis of Migraine Associated Vertigo: #1 a positive reaction to one of the medications used to combat Migraine Associated Vertigo (in my case, my symptoms completely disappeared within three days on the medication), and #2 a look at the symptoms (headache with balance symptoms), as well as for me the fact that my symptoms were so much worse the week before and during my cycle.
I have all the CLASSIC symptoms of Migraine Associated Vertigo. Who can make the diagnosis?
My diagnosis was made by a Neuro-opthalmologist and my second opinion was confirmed by a Neurologist. That’s not to say that another specialist cannot make this diagnosis. It’s always good to start with your primary care physician. I learned that if an ENT suspects a migraine-related condition, they will usually recommend a neurologist because that type of specialist deals with migraine conditions. Migraine Associated Vertigo for some specialists is little known, so a diagnosis may not be given consideration initially. Can Migraine Associated Vertigo be cured?
No. Migraine is often ‘outgrown’, particularly with menopause. This is not universal though - in a few women migraine gets worse after menopause. There is no cure, but the symptoms can often be effectively controlled with migraine preventatives. What are the medications used to treat Migraine Associated Vertigo?
These 2 articles cover much (but not all) of the medications used in migraine. The first talks about the problems of using analgesics (like aspirin and many others) too frequently in migraine. The second is an in-depth discussion of several preventative medications, including Amitriptyline. http://www.aafp.org/afp/971115ap/moore.html http://www.aafp.org/afp/971200ap/noble.html
A few more preventative meds have come out since the articles were published. Your primary care doctor may want to work with a local neurologist to find the right preventative for you. My own personal opinion on medication would be to try something in a low dose first, and definitely refrain from the “higher power” medications initially like Imitrex, which is also used to treat migraine, but is well known for some awful side effects. How do these medications work?
The “usual” medications used to treat migraine conditions work as spasm alleviators to stabilize the spasms of the blood vessels.
However, there are some other medications that are used to treat migraine conditions (like the Amitriptyline) that are more commonly used a pain alleviators – however the Ami (for example) has different components than a “usual” migraine medication, and the effect on the brain is on the neurotransmitters. It is not known why a medication like Ami works so well on this type of migraine condition. Another medication (for example) very similar to the Ami is Nortriptyline. However, since the properties of the Nori are slightly different than the Ami, if a person gets great results on the AMi and then they try the Nori, they may get NO alleviation from their symptoms on the Nori. Because every one is different, a person may need to try a few different medications before finding one that alleviates the symptoms with tolerable or no side effects.
Currently, I take two plain 500 mg aspirin mixed with a treaspoon of Children's Liquid Benedryl. Always ask you r doctor first before trying any kind of medications.
Years ago when my symptoms were almost intolerable, I went to a gamut of specialists. There were two specialists out of the group that suggested I was experiencing Migraine Associated Vertigo. I really didn’t know what it meant, as no-one took the time to completely explain it to me. I thought “migraine” only meant those truly bad headaches where you had to lie in a dark room and vomit until it passed. So, I blew it off as another misdiagnosis and continued my search. Back then, I was very emotional over my symptoms and fuzzy-headed, so I can only think that these were also some of the reasons why I didn’t pursue learning more about this condition.
Along the way, I did make additional calls to other medical fields – like Physical Therapy. Two of the physical therapists that I spoke to out of state who dealt with vestibular conditions also told me that I "probably had a little known condition called Migraine Associated Vertigo".
I followed this up with a call to my neurologist, who knows me well. He told me that he was in agreement with the initial diagnosis of Migraine Associated Vertigo that I had received so long ago.
My answers on here were based on the information I gained from my discussions and reading about Migraine Associated Vertigo, and my own experience with my symptoms.
Maybe this information will help someone on here. xo