ENT Manifestations of Migraine 5: sinus pressure, vertigo and BPPV

Many patients who present to the otolaryngologist have manifestations of migraine that respond to migraine management but do not look like the typical migraine headache physicians and patients are familiar with. Headache may be absent altogether in these patients. We can confirm the diagnosis by recognizing common patterns of symptoms in these patients. 89% report facial pressure of some type, 82% report dizziness, 70% have tinnitus and 62% have ear pressure. Patients with migraine are 7.5 times more likely to get BPPV.

[Tad-For-Global-Peace]

Teresa ty, you’re helping me. I have recurring BPPV, also sudden onset 2-3 second vertigo non-positional- happens out of the blue while walking or driving, I also sometimes feel disoriented in grocery stores a few times, and dizziness when scrolling on a device, and sometimes I wake up with slight motion dizziness (not vertigo, no nausea) and I have a unstable gait as tho I am inebriated, this last about a week. I can’t state distinctly that this comes with a migraine because I tend to get daily light background headaches, some are simmering in the background and will intensify during a leg workout or any other stress, and some days 2 or 3) it’s a full migraine requiring ibuprofen. Each month i a get a 3 day ice pick stabbing intermittent 2-3 headache in my temple, over and over, every 10-20 minutes. It can start in my eyebrow as a constant pain then migrate to the temple where it looks like what is known as “ice pick) This is different from SUNCT I gather. I have been diagnosed w VM and BPPV. Family has migraines, without aura that I know. I do have transient tinnitus which sometimes comes immediately preceding a sudden 3 second ear pressure feeling Where I feel like I am going to go deaf, sometimes following that three second sudden ear pressure I feel as though my ears popped and I could hear louder, and I hear a loud static sound for a few seconds. This happens about twice a month. My ears are sensitive to pressure because if I’m in the car and going up a hill, I can feel a little bit of pain in my ears and if you roll the window up while on an elevated road you have to roll it up very very slowly because too quickly will hurt my ears. A couple times a year for a day or two I can hear my voice and my ear gets clogged. All these symptoms started happening a few years ago when perimenopause (PM) hit, I have always had migraines here and there as a kid and as a young adult when it would rain or it would be very hot and maybe sometimes during menstruation. Im now in perimenopause which brought a new pattern of migraines for me. Phase one of PM I got 3 days right side throbbing migraines. Phase Two came vestibular ear, vertigo, balance issues. Are hormones the culprit? Maybe or in part. I’ve always been affected by hormone fluctuations: PMS/PMDDand seemingly more so than friends. I wonder if there’s a connection with vestibular migraine groups of women who all have a history of hyper sensitivity to PMS hormonal fluctuations and then when they all enter perimenopause do these fluctuations in hormones cause vestibular migraines.

I also have monocluos (spelling) triggered by low decimal sound of central fan going on in the bathroom, that muscle flutters and it hurts, thank goodness it stops if I drown out the sound or leave the bathroom.

I appreciate all of these testimonies; They are very helpful. I wish everyone reading that they fine a way to recover and or a successful way to manage these issues.

[MrsYoung-inov]

Noritriptyline works very well for me too! Similar symptoms