My First Vestibular Attack
I have been having horrible headaches since I was in high school. They have waxed and waned over the years in frequency and intensity. However, more recently, I have developed a new and disturbing aspect of my migraines: vestibular (vertigo) episodes. I am now coming up quickly on the one-year anniversary of my first major vestibular episode. It's been a wild ride, and I am still learning to cope and adapt to this new aspect of my migraines.
It started with a headache
It started like this: Last year, there was a rare snowstorm in late October. I had a really horrible headache, the kind that had me feeling queasy and wincing from lights and noise. I took ibuprofen and Tylenol and rested much of the day after a lunchtime work-related meeting. The headache subsided by the early evening, and I felt mostly fine. The rest of my evening passed by without incident, and I actually went to bed feeling pretty good.
Then the room was spinning
Fast forward five hours later: I woke up in the pre-dawn hour of around 5 am when it was still dark. Right away, I could tell something was off. I was shivering and sweating at the same time. I felt terribly nauseous and felt like I immediately needed to use a restroom to relieve my bowels. But most critically, when I opened my eyes, the room was spinning violently. It was the kind of spinning that reminded me of being on the Tilt-A-Whirl as a teenager - that ride with the spinning cups.
A trip to the ER
The spinning continued and continued and did not subside as past incidences of vertigo I have had have. It was also the most severe case of vertigo I had ever experienced by far. After several minutes of spinning, I had my boyfriend call 911, as I was worried I had a stroke or aneurysm. The ambulance arrived within minutes, and I was carted away to the ER. There, I was subjected to a spate of tests, including a CAT scan of my brain, blood work, and an EKG. I was offered Ativan through an IV to calm the dizziness. After hours of testing proved inconclusive, I was sent home.
Several weeks of testing
Over the next several weeks, I had more tests, including an MRI of my brain, which yielded nothing new or worrisome. The vertigo continued on and off for several weeks but was much milder and didn't last as long. I mostly had a general sense of imbalance or wobbliness, like walking on a boat that took more than a full month to fully recede.
Was it triggered by migraine?
After a process of elimination, my ENT (Ear, Nose, and Throat) doctor thought that my vestibular event might have been triggered by a migraine as the event followed a truly terrible headache. This suspicion has been reinforced as most of my vestibular attacks have abetted or usually shortly followed (usually within 24 hours) a migraine-caliber headache. It may not be the only reason for the vestibular event I experienced that day and the others I have since (as I will explore further in later posts), but it's clear migraines are playing a partial, if not primary, role. There is a term for this: vestibular migraine.
Each vestibular attack is different
As I stated, I am still learning to cope and adapt to this even one year into it. Sometimes, I can feel well for weeks at a time, maybe even a month, but then I will get another vestibular episode that knocks me out of commission. Sometimes they go as quickly as they come. Other times they linger for days or even a week or more. It has made my life a bit unpredictable. While they mostly follow headaches, sometimes they don't, and other times I have horrible headaches, and no vestibular event follows.
Have you noticed something that used to trigger your migraine no longer does?