Help! New with Vertigo and migraine?

I usually post over in the hepititis forum...for issues with husband.

I have been down with vertigo for 4+ days now.  I saw ENT yesterday and he is suggesting this may be a migraine?  Can anyone shed light on this for me?  What can I do to feel better?  I have basically been in bed sleeping.  Only getting up to go to bathroom.  Sipping water and eating very little.  I have missed 3 days of work last week and am freaking out.  I have to be back at work on Monday.

This is my 6th vertigo espisode since January 2008.  Spaced many months apart.  This is 2nd worse one...the first one was the worst.  All lasted about 3 days.  But as I mentioned above, this is over 4 days now.

Any and all advice is welcome.

Emma

Hi Emma,

Sorry to hear your feeling so under the weather. Really bad vertigo can be absolutely brutal.

Yes, your ENT is correct. Vertigo and migraine often go hand and hand. Many of us find that when we have an "attack," we also experience nausea and vertigo.

Just like with Hepatitis (type A, B, C ; various subtypes), there are different forms of migraine (with aura, without aura, rare variants, trauma induced). With each form of migraine you have the potential to experience vertigo along with your other symptoms.

Sometimes vertigo is the ONLY thing that you experience. My understanding (may be incorrect) is that this occurs when you have migraine with aura without headache. The vertigo is your (non-visual) aura.

Now this is where my understanding gets really fuzzy, so someone please correct me if I get this wrong. Migraine Associate Vertigo (MAV) is a broad umbrella term used to describe vertigo that presents with any type of migraine. You can do an internet search of MAV on your own. There are loads of websites on the topic. MAV is treated with standard migraine drugs, but first line treatment for MAV is generally 1/2nd line treatment for migraine.

Here is a review article that discusses treatment options:

http://emedicine.medscape.com/article/884136-overview

You may want to try Verapamil first (low side effect profile and first line therapy for MAV), then move onto something like nortriptyline or a beta blocker (propranolol, metoprolol) if it doesn't work. These take a while to kick in. Please don't give up too quickly.

There are some supplements that can be effective: Ginger ( I have heard glowing reviews about New Chapter brands ultra concentrated capsules) and ginko bilboa ( You must absolutely clear this with your doctor before taking it to make sure there will not be an interaction with current meds. Huge interaction potential). Just like prescription meds, these can take a while to kick in.

Migraine is a often triggered by a single or combination of "triggers." These can be hormone, food, sleep, ect. related. We migraineurs often keep migraine journals to systematically identify and eliminate our triggers. I would recommend doing this. Search for examples online. I've got to run, but I hope this helps!

P.S. For low grade bouts of nausea, I make myself a tea of: fresh ginger (an ounce or two), basil leaf (3-4 leafs, italian, not thai variety) and 2 dried bay leaf. Don't drink if pregnant. It's worth a shot.

Post Edited (EvilFluorescents) : 3/5/2011 5:11:09 PM (GMT-7)

If you go to urgent care ask for some type of antiemetic pill (anti-nausea). If you're having trouble holding down pills ask for the pill in suppository form.

They may suggest taking a triptan (eg imitrex). If they do, ask them to rule out basilar migraine and retinal migraine (you have not mentioned any associated symptoms and these are exceedingly rare). It would be a clear contraindication to taking triptans.

Bingo! you have just listed many possible triggers.

1) When you feel better eat regular meals throughout the day. Fluctuations in blood sugar, or drops in blood sugar can be a trigger. You may find that if you eat 5 small vs 3 large meals, you eat less in total. This should also increase your metabolism.

2) stress can lower your migraine threshold.

3) lack of sleep can set off a migraine.

The lights hurting your eyes are another symptom of the migraine. When the nausea clears up so will that.

Best!

Sorry you are still feeling under the weather.

The (pill form of) imitrex should kick in within an hour or two (sometimes it works a little faster).

You may find it makes you very sleepy and just knocks you out. Go with the flow and sleep.

Best of luck!

had one 50 mg at 5:15. it is now 6:45 and aside from being sleepy, i don't notice a difference. will take another 50 mg at 7:15. ugh. i just want to be better. :(

i ended up taking a 3rd pill. i am not spinning anymore (good) but i feel tired, weak, just plain exhausted. have a small headache...still no appetite, a bit nauseated. balance a bit off.

when will i be normal again?

how do i know if the meds completely "broke" the migraine?

feeling sleepy. headache (not a major one) on right side. did not respond to nap and ice pack. should i try OTC meds that i usually use for headache or another imitrex? i think i will try the OTC meds. also have been having diarrhea. isn't this a possible side effect of the imitrex?

i hate this.

emma

took one extra strength excedrine at 7:45 pm pst.  headace gone by 8:45.   that is good.  have exchanged emails with doctor.  she will be referring me to neurologist.  is a neuro the "headache" doctor?

Post Edited (healthynow) : 3/7/2011 9:55:23 PM (GMT-7)

one excedrine worked and it fooled me bacuase for a small window last night i was starting to feel really good. by bedtime i was tired and wiped out again.

this morning i was unsteady and tired.

how can i be so tired when all i do is sleep or sit on the couch??!!

had a bit more of an appetite today. eating no salt saltines, a glass of grape juice, slice of watermelon. even had 2 saltines with creamy peanut butter.

was feeling pretty good for a few hours, working from home on the computer.

this whole experience has really made me feel like a weakling. lost alot of confidence. sometimes i seem to be crying for no reason. i feel scared. i want to wake up and be back to NORMAL. i am feeling very sorry for myself. i want to go to work. i feel scared that my boss is mad...and that adds to my stress.

sorry for the pity party...

emma

thanks EF. your words have helped me through this. i have a phone appt with my regular doctor in the morning and she is making a referral to neuro.

had another headache tonight. one excedrine took care of it.

was crying again like a teenager. feels really emotional.

husband cooked dinner tonight and it actually smelled good. that brought to my attention that i don't remember smelling much of anything in the way of food smells this last week. is that weird?

still tired, but better than yesterday. still wobbly, but better than yesterday. still no appetite or interest in food. phone appt went well---doc says neuro dept should call me by end of week for consult appt. worked for 1/2 day today. just tired this afternoon. and...actually feeling hopeful!!!!