A positive treatment turn out for MAV

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Here is a post about MAV (Vestibular migraines) I made.

I fell going up the stairs today. I had felt a little wobbly and dizzy. Off-kilter as it was. Then just started with the internal vertigo and somehow ended up planted forward on my hands and knees. I got up and began to go up and slammed into the wall, which likely accounts for how I fell to begin with… as soon as you get that falling to the side sensation your body ‘compensates’ poorly by flinging you in some random direction which usually makes the whole situation worse. Needless the say I was rather carefully holding the wall on the remainder of the climb.

This is the best imagine I have seen to show a person what it feels like to walk with vertigo. When you get a drop attack… the ground feels like it is gone beneath on leg and you just fall in that direction. And this is sort of the mild version of that type of vertigo… the ground feels like moosh. Like every step you take your feet are sinking into the ground just a little, or a lot, and the ground is shifting a bit as you do. So it is very unstable. And you can lurch and stagger but either way, you are careful when you walk. And it is common for me to get this also when lying down so I feel this dropping sensation in a constant pulse… drop, stable, drop, stable. Drives me nuts and impossible to sleep like that.
 

Continue reading “A positive treatment turn out for MAV”

MAV, Vesitbular migraines

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I have had vertigo for around 6 years now. Bouts of it for hours, weeks or even months. I feel these constant dropping sensations, swaying when I move. I can’t stand for long, walk for long. Sitting is uncomfortable with this dropping, tiling, swaying. Lot of equilibrium issues as the ground feels unable like my feet are sinking into it. I also get the other symptoms including tinnitus.

Migraine associated vertigo can have these effects : “dizziness; motion intolerance with respect to head, eyes, and/or body; spontaneous vertigo attacks (often accompanied by nausea and vomiting); diminished eye focus with photosensitivity; sound sensitivity and tinnitus; balance loss and ataxia; cervicalgia (neck pain) with associated muscle spasms in the upper cervical spine musculature; confusion with altered cognition; spatial disorientation; and anxiety/panic.” Migraine Associated Vertigo  

“Migraine-associated vertigo (MAV) is a syndrome consisting of dizziness and/or vertigo that is suspected to be related to migraine. Many patients diagnosed with MAV do not have headaches, or have chronic non-specific headaches that don’t fit into the migraine classification developed by the International Headache Society. The cause of this condition is unknown but progress is being made through clinical experience and genetic research. This condition was previously rarely diagnosed, but is now proving to be one of the most common causes of chronic dizziness and/or recurrent vertigo. Sufferers often describe chronic dizziness and dysequilibrium in the form of a “rocking” sensation when still, recurrent episodes of rotational vertigo, chronic daily headaches, migraine headaches, light sensitivity, poor visual acuity and other changes in vision, visual “snow”, nausea and severe motion intolerance. Many of these symptoms cannot be objectively observed or tested for, so physical and neurological examinations (including neuroimaging) are often completely normal. Patients generally do not have all of these symptoms – in fact those with chronic dizziness have quite often not experienced acute rotational vertigo or even a migraine headache. MAV is often misdiagnosed as Meniere’s Disease, Vestibular Neuritis or as a psychiatric disorder. A condition previously described, known as “atypical Meniere’s” is no longer recognised and is believed to be a migrainous vertigo sydnrome. ” http://www.mvertigo.org/

Migraine associated vertigo (MAV) is the old name and still often used but the new diagnostic name is vestibular migraines.. Migraines with vestibular symptoms associated with them. However, some of us have many attacks outside of a migraine which is why we often use the term MAV so often because it migraine associated vertigo, with or without a migraine, nevertheless, the correct term is vestibular migraines and those of us that get vertigo bouts outside of our migraines are just more rare and they might have to broaden the category to chronic vestibular migraines in the future.

“Migraine-associated vertigo (MAV) is a syndrome consisting of dizziness and/or vertigo that is suspected to be related to migraine. Many patients diagnosed with MAV do not have headaches, or have chronic non-specific headaches that don’t fit into the migraine classification developed by the International Headache Society.
The cause of this condition is unknown but progress is being made through clinical experience and genetic research. This condition was previously rarely diagnosed, but is now proving to be one of the most common causes of chronic dizziness and/or recurrent vertigo.

Sufferers often describe chronic dizziness and dysequilibrium in the form of a “rocking” sensation when still, recurrent episodes of rotational vertigo, chronic daily headaches, migraine headaches, light sensitivity, poor visual acuity and other changes in vision, visual “snow”, nausea and severe motion intolerance. Many of these symptoms cannot be objectively observed or tested for, so physical and neurological examinations (including neuroimaging) are often completely normal. Patients generally do not have all of these symptoms – in fact those with chronic dizziness have quite often not experienced acute rotational vertigo or even a migraine headache.

MAV is often misdiagnosed as Meniere’s Disease, Vestibular Neuritis or as a psychiatric disorder. A condition previously described, known as “atypical Meniere’s” is no longer recognised and is believed to be a migrainous vertigo sydnrome. ” http://www.mvertigo.org/

MAV is often mistaken for Meniere’s Disease

I have been given two new medications to help treat my vertigo issues. Zofran for the nausea and SERC for the vertigo itself.

SERC is actually used to treat Meniere’s Disease but sometimes its symptoms and migraine associated vertigo (vestibular migraines) are extremely similar. As they are in my case. My doctor asked me if I get vertigo, nausea, tinnitus and hearing loss and I do. But I also get the sort of vertigo associated with meniere’s.

“A typical attack of Meniere’s disease is preceded by fullness in one ear. Hearing fluctuation or changes in tinnitus may also precede an attack. A Meniere’s episode generally involves severe vertigo (spinning), imbalance, nausea and vomiting. The average attack lasts two to four hours. Following a severe attack, most people find that they are exhausted and must sleep for several hours. There is a large amount of variability in the duration of symptoms. Some people experience brief “shocks”, and others have constant unsteadiness. An unusual variant is the “invisible hand”, where individuals feel as if they are being pushed over. High sensitivity to visual stimuli (visual dependence) is common. (Lacour, 1997). During the attack the eyes jump (this is called “nystagmus”).A particularly disabling symptom is a sudden fall. These typically occur without warning. These falls are called “otolithic crisis of Tumarkin”, from the original description of Tumarkin (1936). They are attributed to sudden mechanical deformation of the otolith organs (utricle and saccule), causing a sudden activation of vestibular reflexes. Patients suddenly feel that they are tilted or falling (although they may be straight), and bring about much of the rapid repositioning themselves. This is a very disabling symptom as it occurs without warning and can result in severe injury. Often destructive treatment (e.g. labyrinthectomy or vestibular nerve section) is the only way to manage this problem. Other otologic conditions also occasionally are associated with Tumarkin type falls (Black et al, 1982; Ishiyama et al, 2003). See here for more information about drop attacks.” dizziness-and-balance.com

In particular my severe bouts do not tend to last long, but after I get a severe bout I have long lasting mild to moderate vertigo. The mild to moderate vertigo can last days to months. But the severe bouts tend to last hours or at most a day. Which is good because you can’t do anything during it. And I also am very prone to sudden drop attacks. In fact, they are so common I consider them to be a primary feature to my vertigo… this sudden severe spontaneous drop followed by prolonged instability.  S severe bout of vertigo always comes with an increase in tinnitus in one ear and sometimes with a muffled hearing in that same ear. Lately due to having to commute to work (motion being one of my sure-fire triggers) I have had a constant instability with brief bursts of moderate vertigo shocks and then sudden bouts of either drop attacks or severe vertigo. It has not been pleasant. Thus the medication change. My doctor suggested I may try not commuting, as in relocating to a workplace branch in my city, rather than the nearby city thirty minutes from home, but I will have to see if such a change is remotely conceivable within the organization. They tend not to consider my health issues to be disabling to be honest. She did write me a doctors note, but this is not like a sick note for a sick day… this is a ‘hey would you consider moving her to an entirely different location because I recommend it?’ I doubt they will go for it, considering my past history of requests and their responses. But I can ask. I mean two new medications to ‘hopefully’ manage this vertigo enough that I can walk and eat… or just not commute and my existing medication will be sufficient. Seems like such a simple solution. But nothing is ever, ever simple with a chronic illness.

Also I do not want to work at the closest branch a it is a horrible working environment. The vertigo has been slowly improving. And I have had mostly instability equilibrium issues lately.