Migraine associated vertigo

Migraine is generally know as a condition causing headaches. It can, however, cause dizziness. Indeed this is a common symptom of standard migraine. If the dizziness is the dominant problem the condition is usually labelled as migraine associated vertigo (MAV) or migraineous vertigo (MV). The dizziness can vary from mild unsteadiness to violent disabling spinning dizziness/vertigo. It can last from seconds to days or even be present continuously. Often there is nausea and occasionally vomiting. Although the dizziness can be related to episodes of headache, it is common that headaches are mild or absent at the time when the dizziness is present. There may be associated pain in the ear or a sensation of fullness in the ear. In some patients there are no headaches. It is important however to be aware that pains in the neck, sinuses, ear or jaw may in fact be a type of migraine pain. Other symptoms of migraine can include flashing lights or zigzag lines in the visual field, sensitivity to light, sound, touch (sensitive scalp skin), odours or flavours Some patients may experience blurred vision or difficulty in concentrating/speaking. Tingling and numbness in the face, arms, hands, legs or feet can also occur although these can also be symptoms of a stroke or mini-stroke (TIA). In women there may be an exacerbation of symptoms at the time of their period. Other factors which can exacerbate or trigger migraine include stress, lack of sleep, too much sleep, dietary factors (eg alcohol, cheese, chocolate, monosodium glutamate, certain preservatives in food, colouring in food or drinks, citrus fruit). Patients may also not tolerate computer screens or reading. If hearing loss or tinnitus is present it is difficult to differentiate the problem from Menière’s disease. Migraine and Ménière’s disease can have similar symptoms. Indeed these 2 conditions may overlap or be due to the same underlying problem. The cause for migraine and Ménière’s disease is unknown. Other conditions which often coexist with migraine include IBS (irritable bowel syndrome), chronic fatigue syndrome, TMJ (temporal mandibular joint) dysfunction, fibromyalgia and chronic pelvic pain. See also here. Migraine can present in many bizarre ways. Dr Oliver Sack’s book Migraine has some interesting accounts of such cases.

 

Management

See here.