{"id":227,"date":"2019-07-03T11:20:50","date_gmt":"2019-07-03T17:20:20","guid":{"rendered":"https:\/\/santafeent.fm1.dev\/balance\/vestibular-neuronitis\/"},"modified":"2020-01-09T14:56:50","modified_gmt":"2020-01-09T21:56:50","slug":"vestibular-migrane","status":"publish","type":"page","link":"https:\/\/santafeent.com\/balance\/vestibular-migrane\/","title":{"rendered":"Vestibular Migrane"},"content":{"rendered":"\n<p><strong>What is Vertigo?<\/strong><\/p>\n\n\n\n<p>Vertigo is the symptom of \u2018false\nmovement\u2019 where the patient feels as if the room is spinning, tumbling, or\nmoving from side to side, even though the room is not really moving.&nbsp; It may also be the sense that things are\nspinning inside the patient\u2019s head.&nbsp; It\noccurs because the brain is receiving conflicting sensory input from vision,\nmuscles and joints (proprioception), or the inner ear (vestibular system) and\n\u2018cannot figure out which way is up and which way is down\u2019.&nbsp; <\/p>\n\n\n\n<p>Vertigo is almost always due to either a problem with the inner ear (vestibular system) or the brain.&nbsp; The initial evaluation of vertigo or balance problems will always involve your physician looking at the history of your symptoms to determine if the pattern of your symptoms fits that of a brain (neurologic) problem such as a stroke or migraine.&nbsp; There are also specific physical exam findings that suggest a brain problem\u2026 weakness of your facial movement, loss of movement of your arms or legs, and difficulty speaking.&nbsp; <\/p>\n\n\n\n<p>However, there are also several\ninteresting points about the character of vertigo with the diagnosis of\nVestibular Migraine:<\/p>\n\n\n\n<ul><li>The vertigo with Vestibular Migraine may instead\nhave severe intolerance to sudden motion, balance problems, dizziness, or a\nrocking\/swimming sensation.<\/li><li>The vertigo and migraine headaches may not occur\ntogether.<\/li><li>The vertigo may start to occur years after the\nmigraine headaches.<\/li><li>The vertigo is \u2018variable in timing\u2019, as it may\nlast seconds, minutes, hours or days.<\/li><\/ul>\n\n\n\n<p>Your physician may also recommend\na number of diagnostic studies to look at your <strong>brain<\/strong> and inner ear (<strong>vestibular\nsystem<\/strong>).<\/p>\n\n\n\n<ul><li>(MRI scan);<\/li><li>Audiogram, Videonystagmography (VNG);<\/li><li>Sensory Organizational Performance Test\u2026 the\nability of your brain to sort out the use of vision, proprioception, and the vestibular\nsystem.<\/li><\/ul>\n\n\n\n<p><strong>What is Vestibular Migraine?<\/strong> The basic problem is that many patients who have migraine headaches also have vertigo or motion intolerance as part of their symptom complex.&nbsp; However, if we were to focus on only their vertigo and motion intolerance, these patient\u2019s symptoms  do not fit into a clear pattern\nas seen with other inner ear problems such as Meniere\u2019s disease, BPPV, or\nvestibular neuritis.&nbsp; <\/p>\n\n\n\n<p>So, about 15 years ago, groups of\nphysicians that manage migraine (usually neurologists), and groups of\nphysicians that manage inner ear\/vestibular disorders (usually ENT physicians),\nproposed that there should be a new type of migraine \u2013 <strong>Vestibular Migraine<\/strong>.&nbsp; Without\ngetting technical, a patient who has recurring episodes of severe pounding\nheadaches associated with sensitivity to bright lights and\/or loud noises,\nnausea and vomiting, and recurring episodes of vertigo more than likely\nhas Vestibular Migraines.<\/p>\n\n\n\n<p>While we usually use the\ndiagnostic studies to make sure there is not another vestibular (inner ear) disorder\npresent, the clinical picture of a patient with Vestibular Migraine gets\ncomplicated by three problems:<\/p>\n\n\n\n<ul><li>Many of these patients may also have spontaneous occurrences of BPPV;<\/li><li>About 15% of these patients may also fit the diagnosis of Meniere\u2019s Disease; <\/li><li>About 30% of these patients may also have evidence for uncompensated vestibulopathy or permanent damage to the inner ear .&nbsp; <\/li><\/ul>\n\n\n\n<p>Treatment for Vestibular Migraine\nusually involves lifestyle changes to avoid the usual triggers for migraines\u2026 <strong>poor diet, poor sleep, and lack of exercise<\/strong>.\n<\/p>\n\n\n\n<p>The best practical description I\nhave heard is:<\/p>\n\n\n\n<p><strong>&nbsp;\u201cThere is an abnormal brain\nchemistry searching for trouble\u2026 so decrease the triggers.\u201d<\/strong><\/p>\n\n\n\n<p>As a start, there are many\n\u2018migraine diets\u2019 that focus on trying to identify specific food triggers:<\/p>\n\n\n\n<p>In addition, some patients may\nbenefit from the use of medications to prevent the onset of Vestibular\nMigraines.&nbsp; These prophylactic\nmedications may include:<\/p>\n\n\n\n<ul><li>B-blockers\u2026 propranolol<\/li><li>Antidepressants\u2026 nortriptyline<\/li><li>Anticonvulsants (seizure medications)\u2026\ntopiramate<\/li><li>Selective serotonin reuptake inhibitors (SSRI)\u2026 venlafaxine<\/li><li>Magnesium supplements<\/li><\/ul>\n\n\n\n<p>Each of these medications have\nside effects and are usually chosen based upon the patient\u2019s other health\nissues\u2026 such as using a B-blocker (propranolol) in a patient with high blood\npressure.<\/p>\n\n\n\n<p>Lastly, patients having migraines\nthat result in damage to the vestibular system may also develop an\nuncompensated vestibulopathy \u2013 permanent damage to the inner ear\u2019s vestibular\nsystem \u2013 may benefit from the addition of <strong>Vestibular\nRehabilitation<\/strong>.<\/p>\n\n\n<p>Call <span class=\"company-name \">David R Brown MD Ear, Nose and Throat<\/span> at <a href=\"tel:+15058209945\" class=\"phone \"> <span class=\"phNum\">(505) 820-9945<\/span><\/a> for more information or to schedule an appointment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What is Vertigo? Vertigo is the symptom of \u2018false movement\u2019 where the patient feels as if the room is spinning, tumbling, or moving from side to side, even though the room is not really moving.&nbsp; It may also be the sense that things are spinning inside the patient\u2019s head.&nbsp; It occurs because the brain is&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":222,"menu_order":36,"comment_status":"closed","ping_status":"closed","template":"","meta":{"schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":""},"service_tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vestibular Migrane - David R Brown MD Ear, Nose and Throat<\/title>\n<meta name=\"description\" content=\"(505) 820-9945 | What is Vertigo? 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