Vertigo, intervention that may help you.
22 November 2008Migraine: Not just a headache.
In January I had a 6 week vertigo episode. It finally went away but 2 weeks later it was back. Over the past 10 months I have continued to have intermittent episodes of vertigo, usually lasting about 2-3 days and starting when I get out of bed in the morning. Over the 2-3 days the spinning will fade in and out in intensity but it is always present. I went to my M.D. and from there started the trip down the road of the ‘mystery’ vertigo diagnosis. Vertigo can be caused by a plethora of diseases, but it seems it can also be a lone symptom of nothing.
The first question I was always asked is -: vertigo or dizziness? It seems dizziness is defined more as a light headed feeling, vertigo is the true, “I drank too much,” “no, don’t move!”, spinning sensation that induces nausea from the sheer strength of the sensation.
According to the Neurology Channel: Vertigo, or dizziness, is a symptom, not a disease. The term vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in balance (equilibrium). It also may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness. The sensation of movement is called subjective vertigo and the perception of movement in surrounding objects is called objective vertigo. I had/have subjective vertigo.
My first referral was to an ENT specialist, and it was a truly physically distressing appointment. They did put me through vestibular testing, which entailed deliberately pumping air into both my ears to cause the vertigo to come on strong. It was an awful, although necessary, part of the testing. After checking my gait, having me do some physical exercises while they watched, and the results from the vestibular testing, there were no answers! I was sent back to my GP to request a referral to a neurologist. The first ENT could not distinguish the cause of my dizziness. Still thinking I had some kind of ear issue I asked to be referred to a new ENT, and this time the testing was more extensive and also involved a hearing test. They repeated the vestibular testing. This new ENT Dr. suggested it might be a case of Meniere’s“There are two “atypical” forms of Meniere’s Disease, in which there are three (rather than four) symptoms.”Atypical” is one word, where the initial letter “a” means “not.” Therefore, “atypical” means “not typical.” One “atypical” form is “cochlear Meniere’s Disease” (also called “cochlear hydrops”), the symptoms of which are (1) episodic, fluctuating hearing loss, (2) episodic, fluctuating tinnitus, and (3) episodic, fluctuating aural fullness; there is no episodic, fluctuating rotational vertigo (dizziness) in this “atypical” form of Meniere’s Disease. The other “atypical” form is “vestibular Meniere’s Disease” (also called “vestibular hydrops”), the symptoms of which are (1) episodic, fluctuating rotational vertigo, (2) episodic, fluctuating tinnitus, and (3) episodic, fluctuating aural fullness; there is no episodic, fluctuating hearing loss in this “atypical” form of Meniere’s Disease. Some, but not all, patients who start out with atypical Meniere’s Disease sooner or later develop the remaining fourth symptom and thus develop “classic” Meniere’s Disease.
I was sent away with lots of information on Meniere’s which suggested reducing caffeine and salt in order to reduce episodes; which I did try for 6 weeks (and in fact have remained consistent with) but unfortunately it was without success in regards to reducing my dizziness. I was then released from this ENT and did make an appointment with a neurologist. Finally after an informative meeting with this neurology doctor, I had renewed faith. After a round of more tests: blood, an new ENT visit, and an MRI (with and without contrast), he determined that A: I have a very bad case of TMJ and B: I have some significant cervical dejeneration and stiffness. His initial thinking was that both or either of these could potentially be the cause of my vertigo. I have had multiple car accidents involving whiplash and stress on my back/neck area. With these findings my neurologist arranged for a course of physical therapy.
After treatment from the physical therapist, and a self-referral to a chiropractor, I did, like many people who choose this treatment, gain some relief; my neck and TMJ is now much better. “Improvement of vertigonous symptoms by chiropractic treatment was often described. The therapeutic effect of chiropractic treatment in 28 patients with vertigo and purely functional disorders of the upper cervical spine or with a combination of functional disorders of the upper cervical spine and the labyrinth was evaluated. Improvement of vertigonous symptoms on patients with purely functional disorders of the craniovertebral joints as well as on patients with combined functional disorders of the craniovertebral joints and labyrinth could be seen. …”
Even with these treatments I was still suffering from episodes of vertigo every 2 or 3 weeks, it became maddening. After a lot of research, and many tests that showed nothing, I began to suspect that what I was experiencing was in fact migraines. My father has suffered from migraines most of his adult life and I have read that they tend to run in families. Also, at this time my homeopath and I decided to try Bryonia, at first just a 30C pill but gradually she increased my dose to 200C. I finally found some relief. The last major episode I had, I immediately took the Bryonia remedy. After an hour my vertigo was gone. I went back to my neurologist and explained that I had taken the homeopathic remedy; I also discussed with him the research on the internet, and what led me to believe I was actually having vertigo-only migraines. For want of a better diagnosis, we decided that I should try calcium channel blockers to try to manage the symptoms of the migraines. The neurologist has me on a 6 week course of calcium channel blockers, 1 every day. So far I have been migraine free for a whole 6 weeks, which may not seem a long time but that is the longest I have been vertigo free since this problem started in January. My migraines are not typical, but I have since discovered that vertigo only migraines are actually more common than many doctors initially realize. I am still working with my chiropractor and my physical therapist in regards to my TMJ and cervical problems, and using Bryonia and Calcium channel blockers to control my vertigo, although the calcium channel blockers are not a long term solution for me.
If you are struggling with vertigo, dizziness or TMJ, call Dr. Paul or Dr. Susan to see if chiropractic treatment might be right for your problem.
303.674.1500 or email office@fontanachiro.com
Make an adjustment: Stay healthy ~ Be happy.
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November 25th, 2008 at 6:38 am
Sounds like you had a couple of things going on..cervigogenic vertigo is quite common after multiple car accidents and can even increase migraine frequency. The brain and spinal cord can only take so many insults and then things start showing up. Vertigenous migraine is rare (Janet Jackson had this) but when it hits is quite disabling.
If calcium channel blockers cease working, and addition excellent option is Elavil (very low dose 10-50mg) which treats migraine and as an anti-cholinergic agent, calms down the brainstem reducing vertigo.
As a practitioner in neurology, we see these conditions and your descriptions are quite accurate. Vertigo is the sensation that the room is spinning and dysequilibrium is the light-headedness feeling.
Good luck..