Vertigo and dizziness are common problems in migraine sufferers.  In general, as a neurologist, I see a lot of patients with dizziness.  The problem tends to be more prominent in migraineurs.  There are several different potential causes of vertigo, and even more in migraineurs.

Vertigo can be present as a part of migraine, is very common after concussion, and can be caused by a host of middle and inner ear disorders, as well as brain disorders.  In some cases, dizziness can be related to dehydration, blood pressure drops, or heart problems.
 
Vertigo can be an associated symptom of migraine (like nausea and sensitivity to light), it can be an aura-type symptom (preceding the migraine in a very distinct episode), it can be the only manifestation of migraine (migrainous vertigo, a variant of migraine) or it can be a symptom in the general life, intermittently and not associated with actual migraine attacks, of a migraineur, but related to the migraine by the genetic underlying sensitivities.
 
Of course, migraineurs can also get vertigo from the more typical and non-migraine related causes, such as inner ear infections, labyrinthitis, benign positional vertigo, menierie’s disease, other ear problems, and even strokes.
 
It is an interesting and common problem.  It, unfortunately, is very difficult to treat.  Keep yourself well hydrated and ask your doctor if any of your medications can be adding to the problem.  Often times it will go away on it’s own, if it is from a benign cause.  In severe chronic cases of vertigo, a special type of rehabilitation can be useful.

So, back to summertime fun and concussions.  We need to think about it, talk about it, know about it.  Fatal brain injuries are tragic, and thankfully uncommon.  Concussions are surprisingly common, and surprisingly dismissed.  Yet, concussion can be downright dangerous, and can lead to long term consequences for our brains.  We neurologists have some idea about the consequences in adults, and still don’t understand many of the consequences in children.  In adults, concussions can lead to headaches, memory loss, mood changes, depression, dizziness, balance problems, impaired concentration, and more.

Think about safety and your brain.  Protect it.  You might need it one day.  (or tomorrow.)  If you get a concussion, stop doing what you’re doing, rest, and contact your doctor.

Instead, opt for burgers or chicken on the grill not too heavily spiced and without seasoning salt.  Grilled veggies are always a good choice too.  Drink plenty of water, and if you want to have a drink, opt for a vodka or gin drink that’s not too sugary.   And please, have a designated driver.

Peppermint oil appied to the temples and forehead can help relieve a headache.   Bring some with you, or opt for the peppermint tea at the rest stop.

Lots of changes in headaches can occur during pregnancy.  Hormonal fluctuations during the pregnancy can tend to worsen headaches in the earlier stages of pregnancy, and tend to protect against headaches during mid and later stages of pregnancy.  Childbirth itself is a whirlwind of hormones, stress, sleep disruption and metabolic changes in the body that certainly can bring on a migraine, but often the migraine will wait a few weeks to rear it’s very ugly head.  Watch out, though, it could be a bad one!

 Newborns and infants disrupt sleep patterns, and if it’s a first, the stress of being a new parent doubles the danger.  During this time, many women breastfeed their babies and can’t take medications for headaches to worsen the problem.  There are methods that can help, though.  You will have to put yourself first, occasionally, taking time to meditate or relax, do some exercises to help ward off those headaches.

As kids grow up, the headaches they induce mostly stem from stress, but there can be some other situations that are less obvious.  Having a sick child not only stresses a parent, but often disrupts sleep, and can change many lifestyle habits that contribute to headaches such as dietary changes or changes in exercise habits.  Holidays  may bring lots of obvious stressors, but the family vacation?  To some, a smooth sail.  To many, not so much.  Take a vacation on your own, or with your adult partner, for a couple of days when you get back! 

How ’bout those college applications?  Exciting?  Yup.  Watching your child’s hopes and dreams expand and materialize?  Yup.  Pressure?  Yup.  You may think the pressure is all on the kid, but in my experience, the parent is feeling it, sometimes even more.  Does your child’s success reflect on you as a parent?  Well, if you’re feelin’ that a little too much, the headaches are likely to be a sign to back off and take time to reflect on the stuff that really matters. 

So, kids can cause headaches, for sure.  But always remember the joy and hope they bring to our lives.  There has to be some sacrifice, doesn’t there?

Trauma that can lead to dissection includes whiplash type injuries, anything with prolonged hyperextension of the neck, and even cracking your own neck. So be careful out there… protect your head and neck.

A recent study published in the February issue of Archives of Dermatology by Kim, et al., attempted to identify a subtype of migraine that might respond more robustly to this treatment.  The study was small, but certain types of headache seemed to respond better than others.  This type of study needs to be reapeated with larger numbers of patients to see if this is a real phenomenon.  This may help explain, though, the experience of neurologists using botulinum toxin for migraine and other headaches… that some people respond wonderfully, and others get no benefit.  Maybe we were on to something.  In the future, we may be able to use the individual characteristics of a person’s headaches to choose the best treatment options more reliably.

There may be several different characteristics of headaches that may make you a good candidate for the treatment, so you need to speak to your doctor about it.

I am subspecialty trained in headache medicine (and board certified in the specialty as well), so this is my greatest passion perhaps.  But in my experience that has formed my clinical approach, I have found that so many aspects of life affect not only headaches and migraines, but other neurological conditions, and vice versa. 

The brain is a very complex, elegant and powerful organ that fascinates me to no end.  In this blog, I will write about this wonderful organ, and hope to provide insight into current news, underlying disease states (or natural states), and give advice about both neurological conditions and other life issues that may affect neurological conditions. 

I hope you, the reader, can find some helpful points as I write and discuss these topics.