have vestibular migraine instead of Ménière ’ s disease .
Episodes of vertigo in Ménière ’ s disease may be treated with meclizine ( Antivert ), diazepam ( Valium ), or promethazine ( Phenergan ). Your doctor may also advise you to eat a low salt diet or may prescribe a diuretic ( water pill ) to help reduce the frequency of Ménière ’ s attacks . In severe cases , inner ear surgery may be needed .
“ Treatments that target balance disorders combined with migraine therapies may be helpful in the management of disabling balance problems …”
What ’ s the take-home message ?
Dizziness and vertigo can occur from a broad range of health conditions , including migraine . They can also occur when you have an infection , chemical or hormonal imbalances , and anemia . Dizziness and vertigo can be caused by problems in your ear , your brain , or other organs . Because dizziness and vertigo can occur with so many disorders , it is important to contact your physician when you experience these symptoms or if your chronic balance symptoms become worse .
If you experience migraine , you are more likely to also have problems with dizziness and vertigo . At times , the dizziness or vertigo may be part of your migraine episode , as in the case with vestibular migraine . Occasionally , dizzy or vertigo symptoms may be a separate problem , as in motion sickness or Ménière ’ s disease . Be sure to consult your physician about problems with dizziness or vertigo . Treatments that target balance disorders combined with migraine therapies may be helpful in the management of disabling balance problems that commonly occur with migraine .
Case Report
Mary is a healthy 20-year-old woman who has been having problems with dizzy spells for the last 6 months . Normally , she has no problems with dizziness or balance problems . About once a month , she experiences a bout of severe dizziness that lasts a few hours . The dizziness can become so severe that she feels like she is walking on a boat during a storm . If she tries to walk , she veers to the side and is afraid she will fall . In addition to the nausea , she becomes sensitive to sounds and lights during her dizzy attacks and prefers to stay in bed in a dark , quiet room . After the dizziness resolves , she is left with a mild , throbbing headache .
Mary is otherwise in good health and takes no medications besides birth control pills . Her only other problem is migraine headaches which began at the initial onset of her menstrual periods at age 15 . Her migraine headaches start as a severe throbbing pain on one side of her head , and are associated with nausea and sensitivity to light , noises , and smells . The migraine attacks typically occur about twice a month . Treating her migraines early in the attack with sumatriptan is generally effective .
Like Mary , patients with migrainous vertigo often experience migraine without vertigo for many years before having episodes of migraine with vertigo . The duration of balance problems during migrainous vertigo attacks can last between seconds to a full day . Because the balance symptoms are generally quite severe and disabling , patients often do not notice the migraine features that also occur during migrainous vertigo episodes . Once Mary was diagnosed , she used sumatriptan to treat her vertigo episodes as she would her other migraine attacks –
with good relief . HW
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