HEADACHE & MIGRAINE
Migraine headache is one of the more common neurological conditions. In fact it is so common that some people don’t even consider it a disease, but rather a normal variant of the human condition. Although the word migraine conjures up the image of extremely painful headaches, migraine often involves much more than headache. In fact, at times the headache may be minor, or may not even exist.
Many people who experience migraine are familiar with visual aura when, just before the headache, one sees flickering light spots sometimes with dark holes inside or zigzagged light flashes like lightening. These visual phenomenon tend to appear about 15 minutes before the headache.
Classic Symptoms of Migraine
- Severe throbbing headache on one side of the head
- Nausea and vomiting
- Extreme sensitivity to light and noise
- The need to go to a dark, quiet room to sleep
While these symptoms may seem common to migraine sufferers, many people don’t realize there is also an association between migraine and the inner ear and brain mechanisms that influence hearing and balance.
- Extreme sensitivity to motion
- Muffled hearing
- Ear fullness
- Tinnitus or ringing in the ear
The hearing symptoms are associated with Otic Migraine, from the word meaning ear, and often occur without headaches.
The cause of migraine headaches probably relates to both abnormal discharges in cells within the brain and to the constriction of the walls of the blood vessels in and around the brain. Although we don’t completely understand the causes of migraine, we know that it can be provoked or made worse by a number of factors, including:
- Hypoglycemia (low blood sugar)
- Stress and altered sleep patterns
- Chocolate, red wine
- Coffee, sodas with caffeine
- Cheeses, Monosodium glutamate (MSG)
Factors Related to Migraine
- Women are more likely to get migraines than men
- Symptoms are often worse around menstruation
- Family history – migraines have a strong tendency to run in families
We now recognize that there are many variations of migraine and some produce symptoms associated with inner ear balance and mechanisms. We also know that symptoms of migraines can appear independently of headaches. For example, just as some patients can experience a visual aura without the headache, some patients can have balance and hearing issues without the headache. In some cases, patients may have headaches in the remote past, commonly in teenage and young adult years, and now – while having outgrown the headaches – still continue to have some of the other symptoms related to migraine. While some patients do have headaches, either before or after the vestibular symptoms, many may only have an occasional migraine headache and they may never occur at the same time as their vestibular symptoms. In fact, in the majority of patients who have vestibular migraine, the vestibular symptoms and headaches do not occur at the same time. This is why the onset of dizziness by itself makes a correct diagnosis difficult.
Establishing a correct diagnosis requires excluding other conditions that can cause similar symptoms, such as:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Ménierès Disease (also called hydrops)
- Transient Ischemic Attacks (TIAs) or small strokes
- Fluid leaks in the inner ear
- Vestibular nerve irritation
At DaganMD, we provide expertise, skill, and experience for all ear nose and throat symptoms. We approach our patients with compassion and a personal commitment to their care. Our ear nose and throat doctors only use the latest medical technologies and our patients only receive the best ENT treatments available.
Vestibular migraine is treated similarly to other types of migraine.
For attacks of dizziness that include nausea, we use drugs such as meclizine to provide relief of symptoms.
If events are incapacitating or frequent, we use medications to prevent the attacks, including:
- Beta-blocking agents
- Calcium channel blockers
- Tricyclic antidepressants
- Serotonergic agents (SSRIs)
- Gabapentin or Neurontin
- Clonazepam or Klonapin
- Acetazolamide or Diamox
- Sodium valproate or Depakote
- Topiramate or Topamax
- Oxycarbazapine or Trileptal
Your doctor is the best person to guide you through the use of these medications.
We also rely on more natural preventative treatments, such as:
- Avoiding particular foods that might trigger migraines, such as chocolate, red wine, cheese, caffeine and monosodium glutamate (MSG).
- Stress management
- When migraines are associated with menstrual periods, taking a water pill or diuretic and restricting salt intake around the time of menstruation may help.
As with all chronic or unpredictable vestibular disorders, attention to the psychological consequences of the disorder is necessary with appropriate medications and consultations. For almost all patients, the proper combination of diet, exercise and drug treatment (if necessary) will lead to good relief of symptoms and return of a normal lifestyle.
DISCOVER OUR SERVICES
Meet Our Customers
“I’ve been going to Dr. Dagan since 2011 and he’s always been amazing. There’s no question as to whether or not my kids would see him! He’s so wonderful with them both!!!“
“The staff at Dr. Dagan’s office are always so friendly and welcoming! They know their patient files inside out and are so knowledgeable on insurance coverage issues which is a huge boost to seamless care! Dr. Dagan is thorough, thoughtful and kind!“
“Had my first ENT appointment w/ Dr. Dagan, and it was a great experience. Dr. Dagan took his time with answering all my questions, offered some great suggestions for my pain and made me feel very comfortable. I look forward to our follow up.“
“Great doctor and staff. Takes time to explain and answer questions thoroughly and helps you feel comfortable. Very knowledgeable and explains in a way that helps you feel confident in entrusting your health to him.“
“Incredible. Was able to figure out what was wrong after years of the wrong diagnosis by other doctors. Dr. Dagan takes the time to listen as well as thoroughly explain things. No wait time and everyone at the office was super helpful and kind!“