Vertigo like symptoms

by Pratima
(Palo alto, CA, USA)


I suffer from ocular migraines and they started in 2010 when I was pregnant with my first son. I only had attacks when I was pregnant - the second time with my twins. However in 2014 after an intense dance session I got an ocular migraine the next day. I have been having them regularly since then.

I decided to go on a no sugar, no gluten, no coffee, no alcohol and no grains diet. So I eat just vegetables, fruit, nuts and meat. I started this a week ago.

Yesterday (July 26th) I woke up to vertigo that lasted many hours. I went to urgent care and they tried the epley manauver and didn't seem like it went well. So they gave me meclizam. I took another dose last night.

This morning I didn't wake up to vertigo but I just feel out of sorts. Mind you I felt out of sorts when I woke up yesterday too before I took the drug. Do you think this is bpvv? Or something else is going on? One more datapoint is that my vertigo started after a massage. I had two attacks right after my massage. This attack was after 2 days of getting a massage. Do I need to see a chiropractor?

Hello Pratima,
The key here is a correct diagnosis. True vertigo produces a strange movement of the eyes called nystagmus. Google it.

If you don't have nystagmus during an attack then you probably don't have BPPV. There are other causes of vertigo, some serious.

The hallmark test is known as the Hallpike Dix test. It takes some experience to know how to do it correctly but you could ask your spouse to check. Lying on your back, extend the head and neck and then turn first to the left, for about a minute, and then to the right.

Does it provoke vertigo and if he looks at your eyes are they darting to the side or spinning?

Personally I try to avoid cervical manipulation of patients suffering from vertigo; it can aggravate the condition quite seriously and if you have narrowing of the vertebral artery, one cause of nystagmus, then it can be quite serious.

So my suggestion is to first consult a neurologist.

First a diagnosis; then if you it's positively identified as vertigo, the Epleys. Only after all that has failed would I consider a cervical manipulation.

We are treading on difficult, controversial and potentially thin ice; be careful, be wise. Medication doesn't help BPPV.

Consider too the Brandt Daroff exercises.

dr B

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