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    Old 07-05-2004, 04:37 PM   #1
    sickintoronto
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    Does MAV cause balance problems?

    I am still not diagnosed with anything and lately I have been getting some migraine headaches.
    I always thought I had Labs, but now I'm wondering if it could be MAV.
    Does MAV cause the symptoms of having trouble in grocery stores (you know, the eye tracking problems), and balance problems? Or is that more of a Labs thing?
    How do they test for MAV?
    Thanks for any answers!
    (my smillie guy is wearing sunglasses because he has a migraine)

     
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    Old 07-06-2004, 03:30 AM   #2
    shen
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    Re: Does MAV cause balance problems?

    Hey sickintoronto

    I have MAV and i have had really bad balance problems, for three months i couldn't get up off the sofa, go outside or do anything. My eyes felt weird and like you say they still do in shops and aisles.

    My family have had a strong history of migraine but i have only had a couple in my life, (one being the night the dizzies started) from then on i have had balance problems.

    I went to a ENT specialist and took a sheet of paper describing my symptoms had MRI eng caloric and hearing tests all came back normal so the only thing was for me to try was migraine meds to see if i responded, and i have so that how they know if it is MAV.

    I'm one month on Friday into taking the medication and have noticed a slight improvement, although i still feel off balance and my eyes feel strange still however the tablets take a good six weeks to take effect.

    Hope some of that helps

    Shen

     
    Old 07-06-2004, 11:48 AM   #3
    Wowwwweeee
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    Cool Re: Does MAV cause balance problems?

    Hi There,

    I have also been diagnosed with MAV. Here is some information someone may find helpful. I've broken this down into two submissionsm for space.

    Page ONE

    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.


    See next submission....

     
    Old 07-06-2004, 11:53 AM   #4
    Wowwwweeee
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    Cool Re: Does MAV cause balance problems?

    Submission Two....

    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.
    [url="http://www.aafp.org/afp/971115ap/moore.html"]http://www.aafp.org/afp/971115ap/moore.html[/url] [url="http://www.aafp.org/afp/971200ap/noble.html"]http://www.aafp.org/afp/971200ap/noble.html[/url]

    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.

    How do I know all about this?
    I didn’t. If you read my posts on here starting with the Archives, you will see that I have had these symptoms for a VERY long time. I am listed under an older user name (Wowwweee) and my current one.

    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".

    My symptoms all but disappeared for a while. For eight months I was back to my old self: running, going out, lying on my side/flat, at the gym, driving at night, etc. I wasn't on these Boards too much back then! Then my symptoms started up again in April of 2003. When they were at their worst again, I started to investigate these sensations more thoroughly.

    My primary doctor saw me when I was quite discouraged. He is a good man, but does not fully understand my symptoms and therefore, does not know how he should be treating them (for what condition). Most of the specialists I have seen have been at the result of my request. Same with medications after a specialist suggested one. This time, my doctor offered to send me out of state to a Balance Center so I could work with medical professionals who were highly specialized in working with people like me who had some sort of vertigo or woozy or balance condition (there are no Balance Centers in New York State).

    So, I started making some calls to states nearby to locate a Balance Center that I would be able to drive to.

    I found a Balance Center in Indiana, and placed a call to see if I could speak to someone there about treatment. The people there were very sweet, and instead of speaking to a receptionist (which I anticipated, or at the very most, the Office Manager), I was put in touch with the Director of the entire facility. This gentleman took the time to listen to everything I wanted to say, including my idea for going to a Balance Center. He was very patient, and waited until I took a breath, and then told me that he hears about my symptoms all the time. He then went onto state that I didn’t need to pursue a Balance Center, because it was pretty apparent to him that I probably had Migraine Associated Vertigo.

    I asked him a zillion questions, like (most importantly) how did he know that? He explained about how certain inner ear conditions are diagnosed (some of which I didn’t know); but now I know why I didn’t have some of the “inner ear conditions” that I thought I might have. We went over my history of testing and the specialists that I saw.

    He was kind enough to send me some links via e-mail about this condition, as well as some other links pertaining to additional questions I had. In addition, one day I sent him an e-mail asking him if I could pick his brain with more questions, and we spent one full day e-mailing back and forth. I received more information from him in one day, remotely, than I did in speaking to a specialist in his office. What a blessing to have been put in touch with him.

    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.

    I also followed this up with a call to an Apothecary (they are a type of pharmacy that deals with providing special combinations of medications to people) – I wanted to talk to someone more in depth about migraine medications.

    An aside about my medication experience: I got great results with the Ami that I mentioned – within three days my symptoms (wooziness and headache) were completely gone. But after a while, I developed side-ffects of a racing heart beat and difficulty swallowing. I had the racing heart beat checked out by my cardiologist, who told me this a usual side-effect and that it wouldn’t harm my heart. I had my swallowing problem checked out by an ENT who told me that he could “see” nothing wrong. No-one was sure (even the Apothecary) if my swallowing problem was a side-effect of the Ami. But, I went off of it due to fright, and soon my symptoms came back. I am pretty nervous about taking medications, and I haven't taken anything since along those lines, but it's nice to know that there is something that really works for me, if I need it again.

    One last popular question: Can I fly with Migraine Associated Vertigo?
    Yes, but the symptoms may be heightened for a while until things settle. I did fly to Las Vegas in May, see my other post on that.

    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.

    Wishing everone a nice day!

     
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