Migraine in Otolaryngology: Part I , Pathophysiology, Vestibular Migraine,Otalgia,Meniere's Disease

Migraine is a common problem experienced by a large segment of the population. The presence of migraine can mimic or accompany the presentation of common otolaryngologic complaints such as sinus pain, headache, otalgia, vertigo, aural fullness, and fluctuating hearing loss. Many patients experience migraine in ways that exacerbate symptoms from their otolaryngologic problems or suffer migraine symptoms triggered by their otolaryngologic problems and will benefit from migraine therapy. Unfortunately, only patients with severe or debilitating classic migraine tend to receive significant attention from their primary physicians or from neurologists who treat the majority of migraineurs in this country. This lecture will acquaint the practicing Otolaryngologist with an update on the pathophysiology of migraine, vestibular migraine, migrainous otalgia and Meniere's disease. Part II will present sound treatment strategies for patients who have migraine headache or atypical Otolaryngic manifestations of migraine.

Dr John Carey, at Johns Hopkins University made significant content contributions to this presentation.

[jayrockhammer]

So I've been dealing with vestibular migraines for a decade. Only I didn't find out they were vestibular migraines until about three months ago. It's gotten so bad to the point that I have blackouts, vision loss, and vertigo. I also survived two massive heart attacks this year and I'm only 33. I'm at the point where I don't want to live anymore and am so broken I can't even leave the house let alone my bed. I've tried everything.

[jlvc]

Excellent presentation.

A comprehensive and very useful summary for patient education.

Great contribution!!

[classiccarguy]

Excellent content
Much appreciated 🙏

[HOBOLOCO]

Was this gentleman already on a blood pressure medication. If i take propanolol in a much smaller dose 40mg my heart rate gets very low 40 to 45 bpm. He's on over 100 mg. Wouldn't that slows his heart rate too much? Im asking because i have menieres disease have been prescribed propanol for anxiety and high blood pressure and it did seem to help the menieres some.

[dinahsoar]

I've been trying to learn from you, everything I can about vestibular disorders b/c I'm seeing an ENT and I'm hoping to help him help me. I have been suffering, for almost a year, with low frequency tinnitus that sounds like an engine, and at times it roars, but even worse, the floor in my home feels like it is vibrating: any part of my body that touches the floor or that is touching something that touches the floor, like the sofa, feels the floor vibrating.

I have scoured the internet trying to find others with a similar experience and to date have only found one person whose symptoms were almost identical to mine. She said she suffered 10 years with the engine noise and the vibrations, and one day it all disappeared. She has no idea why. She said they moved, that is the only thing that correlates to the symptoms disappearing.

Like my husband, her husband could not feel the vibrations nor hear the engine rumble. Which makes me think the sound and vibrations are not external. YET, when I pick my feet up off the floor I feel no vibrations in my feet. When I stand up from sitting I stop feeling vibrations in my buttocks.

My ENT believes that the vibrations must be external. BUT, my husband can't feel them, nor can my adult children who have visited when I can feel the vibrations.

Initially I was convinced they were externally produced b/c I live on a bluff over a river that has a sand mine operation, plus there are water pumps that supply water to my county in TN. But I changed my mind when I began noticing the symptoms when I was away from home...not all of the time, but once in awhile. I noticed them in my ENT's office, he could feel nothing nor could his assistant.

Of note, when I am riding in a car, the symptoms disappear instantly which makes me think I have a vestibular disorder. I had a VNG test and am waiting for the results of that.

The roaring/engine idle seems to be common among tinnitus sufferers, but the vibrations are not. Or, if they are, none are mentioning them. They affect the quality of my life to the point of misery. I refuse to accept that there is no explanation for this.

My ENT is making a real effort to help me vs saying I'll have to live with it and I am thankful for that. IF you could offer any input concerning the vibrations I'd be extremely thankful.

[FJano]

Can somebody completely recover from VM? Or only managing possible?