Question: "Ocular" Migraine... past several months I have been experiencing vertigo...
Answer:
Full Question:
I am a 56-year-old female with a history of migraines. The last major migraine I can remember having was approximately 5 years ago and at that time it was diagnosed as an ocular migraine. The past several months I have been experiencing vertigo. To the point where I have spells that leave me unable to function in a normal way on a daily basis. The only way to describe the "spells" is: I start becoming very dizzy with extreme motion sickness, dry heaves or vomiting and need to lay down immediately. Sometimes not able to get to bed or couch and have laid down on the floor. I have lost my balance on several occasions and have fallen once or twice. After these spells I end up with a migraine. Not a severe one but a migraine none-the-less. I have been out of work since January and have had a barrage of tests including MRI'S, MRI with Contrast, ENG, etc. Nothing is showing up but I am suffering on a daily basis. I have seen my regular internist, ENT, neurologist, neuro-otologist. and they all confirm I am experiencing vertigo with no known origin. The neuro-otologist has recently prescribed Inderal thinking that perhaps this is all migraine induced. I have been on the Inderal for approximately 2 weeks and this past Monday I had a full blown migraine that kept completely incapacitated for the entire day. Where can I locate more information regarding my symptoms? Is this a common form of migraines? Is there any preventative medication? Medication when the migraine starts? etc.? Thank you for any help you can give me.
Answer:
Dear Sufferer:
This is a really difficult set of questions to answer. Lot's of items get called "ocular" migraine; some of these may represent many other neurologic conditions including TIAs, "small" strokes, vestibular and equilibrium disorders, or even partial complex seizures. There is a rule of thumb in neurology: "Anything can present as anything..."
It does sound like you have ongoing, unremitting vertigo. Have any tests looked at the integrity of the perilymph system in the inner ear? Perilymph fistulas and hydrops can cause very disabling vertigo and nausea. Preventive medications are a one-at-a-time endeavor and neuronal stabilizing agents (read anticonvulsants) may represent a type of treatment for your symptoms.
Good luck,
John Claude Krusz
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