Silent Vestibular Migraine
How can a migraine be silent?
That is a good question without a clear answer. However, there are those who have suffered from migraine episodes for years without knowing it. Why? Because not all migraines lead to pulsating and debilitating headaches. They are said to be “silent.” Yet, people may have periods of head discomfort and of feeling tired and unwell without ever suspecting a migraine.
All migraines are classified as a neurological condition that is tied to genetics. In the silent version, classic migraine signs may be subdued and “triggers” that set it off can be hard to pinpoint.
Dizziness, balance problems, Vertigo!
A silent vestibular migraine is a migraine that spreads to the inner-ear balance system without causing a pounding headache. Yet, patients may notice vestibular issues, such as mild balance disturbances and dizziness that leave them queasy and wobbly. In the milder version, symptoms are not overly distressing and fade away on their own.
The wake-up call may arrive one day in the form of vertigo, by far the most alarming vestibular symptom. Its spinning and room-tilting sensations go beyond dizziness. Vertigo-related motion intolerance can be incapacitating. It often leads to serious nausea and vomiting, which may convince the patient to seek medical help. No matter what, do not brush aside vertigo! Follow through with the doctor!
Spinning events scare patients and greatly worry doctors whose major focus will be on finding the origin of the vertigo itself. Might this be s sign of a stroke? Vestibular neuritis? Could it be the start of Ménière’s Disease or BPPV or both? Eye movements (nystagmus) are studied and of course, tests will be done that might tell which ear triggered the upsetting event.
Vertigo investigations may well stop as the patient improves and tests do not solve the puzzle. Vertigo as a consequence of migraine may not be immediately on the diagnostic menu. Maybe the whirling-and-hurling episode was a onetime occurrence and will never happen again?!
Health history and a different diagnostic direction
Hopefully, the doctor will pry deeper into the patient’s history in order to put the vertigo event into context. Upon further questioning, details describing symptoms of past migraine-type episodes might well emerge.
People may remember periods of sudden, overwhelming fatigue and irritability; of having trouble concentrating or even finding words; of wondering about mystery stomach upsets or yawning attacks; of being affected by weather changes and steep barometric pressure variations; of being over-the-top sensitive to sound or light etc. Have you ever watched TV with sunglasses on? I have.
In the end, migraines are so much more than headaches. If you suspect that you might get silent migraines, ask the doctor about it. As always, getting a diagnosis, and learning about the condition and how to deal with it are the first steps to improved self-confidence and quality of life. It always pays to have information and a plan.
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