Vestibular Migraine & TMJ

by Alexandra
(Miami, FL)

Hello Chiropractic Help,
I am a 23 year old female who was diagnosed with a Vestibular Migraine. I get a lot of headaches throughout the week and with those headaches I get symptoms of disequilibrium, a little ringing in the ear, and stiffness in the jaw.

I've had this already for three years and I've gotten multiple MRI's, MRA's and CT scans and everything comes out normal. When I came across this page and reading about TMJ I remembered when I would get really bad jaw pains that would last for hours. It has made me wonder if these vestibular migraines may have all started from the TMJ. I would like to know where I can see a good chiropractor that can help me with my situation.

Thanks,
Alexandra

Hello Alexandra,
As you've discovered, you're living in a minefield. The great difficulty in all this is to discover what is the primary, underlying cause of all these bizarre symptoms.

Could it be something in your jaw joint, or teeth, or sinuses that is triggering the trigeminal nerve? Or, is it a problem within the ear ear, mostly likely the tiny organs that control once sense of balance. It's directly connected to the eyes. Or is it chocolate, red wine or smelly cheese that's setting it all off. Or, perhaps it's a subluxation in your upper neck, where the sensory nucleus of the trigeminal nucleus is found, triggering pain in the muscles of the face and jaw joint.

Most often, it's you, the patient, who has to work it all out. It's all chicken and egg, and you are the best person, through careful observation to find out what is the primary trigger. There may be more than one, just to add even more difficulties.

Start by doing two little tests, one is easy, and one difficult.

1. Place your index fingers on the jaw joints, just in front of the tragus of the ear. Are they tender? Is one much more tender than the other. Slowly open your mouth and evaluate if they open simultaneously together. Press on the temporalis and masseter muscles. Do they seem inordinately tender and do they cause shooting pain? Place your index finger, pulp outwards, inside your cheek, slide right back to the pterygoid pocket close to the wisdom teeth, and palpate the later pterygoid muscle. Is it very tender on one side? That's the easy one.

2. Have your partner carefully check your eyes when you have an attack of dizziness. Do the pupils zig zag from side to side or in a circle? Lie on a cushion, and put your head and neck into extension, and turn quickly first to one side, back to the centre, and then to the other. Does it make you giddy, and ask your friend if your eyes start to make darting movements? The may last only a few seconds. Look up nystagmus in Google.

3. Turn your head right and left, tilt your head, look up and down. Any inordinate pain? Press on the joints right at the top of your neck, just below the occiput of the skull. Does it seem more tender than it should?

4. Try provoking the symptoms with different foods.

5. Sinuses and grinding of teeth, a bad cavity?

In short, be your own detective.

I hope this contributes. It's difficult, I know.

Dr B.

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