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near constant dizziness after migraine
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near constant dizziness after migraine

Hi all,
Back in June I had one of numerous migraines, I'm a 40 year old male.  I normally have been having migraines a few times a week for years (>10) but this one brought severe dizziness with it.  I thought it was a symptom of the migraine, but 3 months later the dizziness is still here, along with some slight insomnia (wake up 3-5 am every day, no problem falling asleep), and my brain 'skipping a beat' when I got worked up or upset.  I've had heart issues in the past, so the first thing my dr. did was put me on a holter monitor for a few days.  That returned normal, with no issues showing during my dizzy spells. I currently have an ENT appointment set up, but it's not til December, over two months from now.  The dizziness seems to occur when I move between rooms with different lighting or temperature conditions. For example, I get dizzy sticking my hand in the freezer, shopping in the frozen aisle at the market, or moving out of my dark office into well-lit hallways, I've never fallen but am very unsteady and walk much slower.  I've noticed increased anxiety too.  
While waiting for my December appointment, was wondering if others have experienced similar situations and have advice, and suggestions as to what might cause dizziness to linger this long?
Thanks,
R
Avatar_dr_m_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
Some more detail would be needed on your symptom of dizziness. Is it a dizziness as in light-headedness/faint feeling or is it more like vertigo (sensation of room spinning around you or you spinning around in the room). The two require slightly different workup
For the former, a 48-72 hour Holter monitor was a very appropriate workup, especially if you have had some heart issues in past. The Holter would have ruled out cardiac arrhythmia as cause of the light headedness. Other cardiac tests which may be indicated are an echocardiogram. Light-headedness can also be caused by being in a dehydrated state, so ensure you drink lots of fluids and stay hydrated. Another cause of light-headedness can be low blood pressure if you are on a lot of bloodpressure or sedative medications. Anxiety itself can contribute to dizziness
If your dizziness is more of the vertigo nature, then other differentials are benign positional vertigo, which causes episodic vertigo which worsens on neck rotation/movement. If the vertigo happens along with your migraine every time then it might be a feature of your migraine. If you have hearing loss or tinnitus (whooshing/ringing sounds in your ears) then there are diseases like Meniere’s disease and brain tumors which should be ruled out.
I think that seeing ENT is an appropriate next step in evaluation. If you get worsened headaches, worsened vertigo and balance problems, and you have not had a MRI brain yet, it might be a good idea to be evaluated by a neurologist too.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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