Migraine Associated Vertigo (MAV) is a syndrome where continual dizziness is suspected to be related to migraines. It sounds simple, but it's not. It is a very complex condition and difficult to diagnose. The dizziness is not usually accompanied by a headache, or if it is, may not be your typical migraine type headache.
MAV at one time was rarely diagnosed, but it is now being considered the most common cause of chronic dizziness.
Research through clinical experience and genetics is being done in an effort to find the cause, but at time of writing, it is still unknown what causes MAV.
This constant dizziness is often described more as: a disequilibrium, a rocking sensation while still, chronic daily headaches, sensitivity to light, snowing vision, nausea, recurrent spells of vertigo, and at times intolerance to motion. This is because it has to do with middle ear disturbances. See, I told you it was complicated.
You might only experience one of these symptoms or you could have all of these symptoms at different times. If you get migraines, you might get these symptoms away from the classical attack. This causes problems in diagnosing this condition easily, which can often be very frustrating.
The symptoms are mostly objective and although testing can be done, the results usually come back completely normal. This condition is often misdiagnosed as Meniere's disease, vestibular neuritis or a form of a psychiatric disorder. It is also called Vestibular Migraine.
Understanding this dizziness is related to migraines, with no pain, might be difficult at times. And as a patient, you may not know what is going on for quite a while and feel like you are in limbo land.
The good news is that vertigo is treated in the same way as "normal" migraines.
• Consult with a neurologist that has a special interest in migraines.
• Prophylactic medication(s) can be used if the MAV occurs several times a month or is continuous over several weeks or months.
• Avoid common food triggers like: red wine, MSG, other alcoholic beverages such bourbon, scotch, port or sherry, aged cheese, chocolate, and aspartame.
You can read more about this in our common migraine triggers article.
• Avoid stress and anxiety.
• Avoid smoking (second hand smoke included).
• Avoid birth control pills and estrogen.
• Vestibular rehabilitation therapy is recommended if the movement associated with disequilibrium is present. This is normally with a specialized physiotherapist to regain strength and hopefully balance.
Vestibular Rehabilitation Therapy (VRT) is a physical exercise program designed to promote central nervous system reparation for inner ear problems. It uses specialized physical exercises that result in gaze and gait stabilization.
This involves head movements which are essential in stimulating and retraining the vestibular system. For more details please click on the resources below.
The do's and don'ts of attempting to find the triggers for this vertigo has its challenges.
Monosodium glutamate or MSG is often found in certain soups, Chinese food, and some fast foods.
It can also be hidden in some foods, so you will need to read the small print on labels. You can even call the manufacturer if in doubt.
An elimination diet for a month or so may be of some benefit to attempt to find these triggers.
Add one of these foods back at a time until the symptom returns. If you keep a migraine diary and journal, you can track your triggers a little easier.
There are certain things you just can’t change. I thought I could “cure” my migraines for way too many years.
Here are some facts to help you face reality of this debilitating condition.
Fact 1: Migraine Associated Vertigo occurs mostly in woman and it can happen at any age.
Fact 2: The cause of MAV is still not fully understood and is therefore hard to diagnose.
Fact 3: Sadly, if you have migraines in your youth, you may develop vertigo later in life.
Fact 4: Medical treatment for migraine associated vertigo is similar to treating migraine headaches.
Fact 5: Migraines are a lifelong condition. MAV, the same. It is genetic and can be inherited.
With any chronic illness you need coping skills to manage it.
Your first step is to find a good doctor who can work with migraines. Let him/her rule out the more serious life threatening conditions.
And then figure out your best way forward.
I use the Korjo wrist bands with every attack accompanied by nausea.
Here is my recipe for Ginger tea, it works a treat.
Oh, and holding onto something when you need to walk helps me! A wall, a chair, the floor!
Important Migraine Associated Vertigo Links:
1. Vestibular Rehabilitation Therapy (VRT) at Vestibular.org.
2. Vestibular Rehabilitation Therapy at MedScape.com.
Migraine Associated Vertigo: Do’s and Don’ts