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Neurology (Expert Forum)
Vestibular vs Basilar Migraine
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Vestibular vs Basilar Migraine
by Rhiannon, Jan 28, 2001 12:00AM
Hello and thank you for your time,
I have been given the diag of Vestibular Migraine by a Neurologist(Neroscience Inst of New Jersey).Since childhood I have had migraines with nausea and vomiting,mother also.The beginning of 2000 I had 4 severe headaches in the back of my head some with vomiting some without, no neuro/vestibular symptoms that I remember.I was also having short dizzy spells,walking like I was drunk,severe hearing sensitivity/high pitched ringing,and light sensitivity without headache.The severe headaches subsided to mild frequent ones ,back of head or front around my eye.I have had worsening hearing sensitivity/ringing the same,light sensitivity( lights on/off bothers me)loss of balance,feel like Im tipping over to the left,motion sickness w/queasey stomache,clumsy,episodes of "coma like state" feel like I was drugged,hard to "get out of it",I usually feel lethargic before the "coma event",sometimes feel like ice water is running down my legs??,eyes become tired and the muscles around them "tremble" when I drive for more than 45 mins.I recently have been having periods of significant leg and arm weakness,and also periods of lightheadedness.Trouble swallowing at times also,motility related?The grocery store makes balance symptoms worse,overload of lights,sound motion?
I have had:BSER-OK ENG/ABR positional test= nystgmus 3 out of 7 positions,indicates vestibular dysfunction cannot be further localized,caloric weakness 7% left ear, directional prepoderance 11% to the left, EKG-OK, MRA-OK, MRI on 3/99-OK,this was for nausea and vomiting,I had been diag with idiopathic gastroparesis on 2/98 and recently colonic inertia/pelvic floor dysfunction.My current health is "poor" I am 5'10" and weigh 104 I have lost 20 lbs with the gastroparesis.
My questions:
Are vestibular and basilar migraine "one and the same" or can just the vestibular blood vessels be effected?
Could the coma event be from basilar migraine?
*I have tried Imitrex and it gave me a worse headache*
Is it possible to have neuro/vestibular symptoms chronically for a year with only brief periods of relief?The headaches come and go and are not as severe,oh I started the Serzone about 2 mo's after the 4 severe headaches at the beginning of 2000.
Indirect question: could my low body weight and inability to really eat "normal" contribute to or worsen this migraine event?
I eat "smart" focus on protien,potassium,drink ensure etc. but I am not always able to consistantly eat well.I do the best I can.
I am currently taking Zofran, Serzone 100mg,Aciphex and was given
Klonopin .5 1/2 tab 2x a day max for vestibular symptoms,I find it helpful.I was also advised to try and increase the Serzone and will be seeing the Neuro again in 6 wks as I obviously have some questions.I would greatly appreciate your input and suggestions.Thanks so much!
Jeannine
I have been given the diag of Vestibular Migraine by a Neurologist(Neroscience Inst of New Jersey).Since childhood I have had migraines with nausea and vomiting,mother also.The beginning of 2000 I had 4 severe headaches in the back of my head some with vomiting some without, no neuro/vestibular symptoms that I remember.I was also having short dizzy spells,walking like I was drunk,severe hearing sensitivity/high pitched ringing,and light sensitivity without headache.The severe headaches subsided to mild frequent ones ,back of head or front around my eye.I have had worsening hearing sensitivity/ringing the same,light sensitivity( lights on/off bothers me)loss of balance,feel like Im tipping over to the left,motion sickness w/queasey stomache,clumsy,episodes of "coma like state" feel like I was drugged,hard to "get out of it",I usually feel lethargic before the "coma event",sometimes feel like ice water is running down my legs??,eyes become tired and the muscles around them "tremble" when I drive for more than 45 mins.I recently have been having periods of significant leg and arm weakness,and also periods of lightheadedness.Trouble swallowing at times also,motility related?The grocery store makes balance symptoms worse,overload of lights,sound motion?
I have had:BSER-OK ENG/ABR positional test= nystgmus 3 out of 7 positions,indicates vestibular dysfunction cannot be further localized,caloric weakness 7% left ear, directional prepoderance 11% to the left, EKG-OK, MRA-OK, MRI on 3/99-OK,this was for nausea and vomiting,I had been diag with idiopathic gastroparesis on 2/98 and recently colonic inertia/pelvic floor dysfunction.My current health is "poor" I am 5'10" and weigh 104 I have lost 20 lbs with the gastroparesis.
My questions:
Are vestibular and basilar migraine "one and the same" or can just the vestibular blood vessels be effected?
Could the coma event be from basilar migraine?
*I have tried Imitrex and it gave me a worse headache*
Is it possible to have neuro/vestibular symptoms chronically for a year with only brief periods of relief?The headaches come and go and are not as severe,oh I started the Serzone about 2 mo's after the 4 severe headaches at the beginning of 2000.
Indirect question: could my low body weight and inability to really eat "normal" contribute to or worsen this migraine event?
I eat "smart" focus on protien,potassium,drink ensure etc. but I am not always able to consistantly eat well.I do the best I can.
I am currently taking Zofran, Serzone 100mg,Aciphex and was given
Klonopin .5 1/2 tab 2x a day max for vestibular symptoms,I find it helpful.I was also advised to try and increase the Serzone and will be seeing the Neuro again in 6 wks as I obviously have some questions.I would greatly appreciate your input and suggestions.Thanks so much!
Jeannine
Doctor's Answer
by CCF Neuro[P] MD, RPS, Jan 28, 2001 12:00AM
Dear Jeannine:
I am sorry to hear about your symptoms. We often seen paroxysmal vertigo in children as a migraine variant. Usually in adults your type of headache we would call a "Basilar Migraine". Here are the criteria and see if they fit, one needs two or more aura symptoms of the following types:
Visual symptoms in both the temporal and nasal fields of visiou
Dysarthria, Vertigo, Tinnitus, decreased hearing, double vision, ataxia, bilateral paraesthesias, bilateral pareses, decreased level of consciousness. I think from what you have told me, you would fit this category. Whether you want to call these vestibular or basilar is likely not important. It sounds like you need to be on a preventative medication. I would ask your neurologist what he/she likes to use. Also, a medication for breakthrough headaches.
You should try and have regular sleep, exercise, meals, avoid chocolate, tyramine-containing food, monosodium glutamate, alcohol, limit caffeine & medications. If this makes things better than you can try and see what you can add back to your lifestyle.
Sincerely,
CCF Neuro MD
I am sorry to hear about your symptoms. We often seen paroxysmal vertigo in children as a migraine variant. Usually in adults your type of headache we would call a "Basilar Migraine". Here are the criteria and see if they fit, one needs two or more aura symptoms of the following types:
Visual symptoms in both the temporal and nasal fields of visiou
Dysarthria, Vertigo, Tinnitus, decreased hearing, double vision, ataxia, bilateral paraesthesias, bilateral pareses, decreased level of consciousness. I think from what you have told me, you would fit this category. Whether you want to call these vestibular or basilar is likely not important. It sounds like you need to be on a preventative medication. I would ask your neurologist what he/she likes to use. Also, a medication for breakthrough headaches.
You should try and have regular sleep, exercise, meals, avoid chocolate, tyramine-containing food, monosodium glutamate, alcohol, limit caffeine & medications. If this makes things better than you can try and see what you can add back to your lifestyle.
Sincerely,
CCF Neuro MD
