brain lesions and vertigo

[larandsandy]

I am a 42 year old female with a long history of migraine headaches.  Actually, I have had them since I was 10 or so.  In 2/04 I had a migraine that lasted 5 days so went to the neurologist and had an MRI done.  The MRI findings were:  Multiple small lesions are seen in the central and subcortical white matter of the cerebral hemispheres with high T2 signal.  These are not ovoid in shape or transversely oriented. In light of the migraine headaches, these probably represent sequelae of vascular headaches.  Diffusion weighted images show no evidence of a recent infarct.  Facial structures appear normal. The visualized portions of the distal internal carotid and vertebral areteries, basilar artery, circle of Willis and the proximal anterior, middle and posterior cerebral arteries all appear normal.  In November of 2005 I awoke to severe vertigo. It actually woke me up from sleeping.  It was very severe as I could not move my head in any direction without the room spinning.  Into the third day of this, I also experienced severe weakness and almost fainted.  I have never had this before.  I have had vertigo before, but much milder.  I did some postural exercises for the vertigo and took benedryl too.  It finally went away about a week or so later, but the weakness lasted for a good month.  I am now better, but still occasionally feel weak and tired.  Do you feel that this was a virus or something like that, or do you think that MS is a possibility.  Also, I can only take Advil for the migraine headaches as I am allergic to acetaminophen.  How often a week is it safe?  Thanks

[CCF-Neuro-M.D.-PW]

Isolated vertigo is unusual in MS, as in this part of the brain there are many closely packed areas that are also affected if there is an MS lesion in this area. So without other evidence of MS, isolated vertigo is unlikely to be MS. What is more common as a cause of vertigo, which is very sensitive to movement of the head, feeling awful, and lasts a few days, is 'benign positional vertigo' caused by dislodegement of some of the inner ear particles that detect and control balance and motion. There is effective treatment in the form of specific positional maneuvres. If it happens again, see a oto-neurologist or ENT.

MRI lesions that are ovoid or transverslt oriented to the brain ventricles are suggestive of MS. That is why they specifically state that they were not present.

Advil can be taken up to 15-20 times a month. More frequent use cna result in medication-rebound headache. If headaches are occurring more frequently than this, you probably need another type of medication to reduce the frequency of the headaches, see you neurologist for more details

[heart2heart]

I have had the same symptoms. Vertigo attacks, fainting, weakness,etc. I have a dx of basilar artery migraine. All my work ups are normal, except in 1994 I had the same little lesions in my brain as you had! Oddly enough my recent MRI showed no lesions. I too questioned whether or not I had MS. I was told many people with migraines or hypertension have these little lesions. It's called small vessel disease. What you should do is get a copy of the MRI, they put them on CD discs now. Take it to a good neurologist - since you've had vertigo attacks I would suggest an Oto-neurologist. You may have to check a major teaching hospital to find this specialist.  They will do tests of your inner ear such as ENG, VEMP, etc. This is to rule out inner ear dysfunction. It sounds like you may have basilar artery migraine. It won't show up on anything, MRI's or MRA's. However you should probably have an MRA done anyway to rule out vascular problems. Good luck to you.

[larandsandy]

thank you for you comment.  I will look into this.  Good Luck to you too.

[SheilaSchnauzie]

A related discussion, New Sx Sound of Blood Rushing Left Ear was started.