Brief Answer:
BPPV vs. OH vs. Migrainous Vertigo

Detailed Answer:

Hi,

If you have headaches and vertigo (whether the 2 occur at the same time or at different times) and if the headaches are of a severe nature to the point of causing symptoms of nausea/vomiting, photo/phonophobia (light/sound sensitivity), pounding or throbbing, and last at least 4 hrs. then, you may have an entity known as MIGRAINOUS VERTIGO. This is generally treated as migraine headaches would be treated with triptan medications (Imitrex and medications similar). In addition, if the symptoms of dizziness or vertigo also had associated nausea/vomiting one could use appropriate medication such as promethazine or phenergan.

If your symptoms come from changing positions such as going from a lying to standing position or even vice versa resulting in sudden bouts of vertigo or dizziness that settle down after a few minutes then, you may have a condition known as BPPV (Benign Paroxysmal Positional Vertigo). The treatment for this is to first be diagnosed by an experienced neurologist or neuro-otologist who can administer what is known as an Epley Maneuver which does not use any medication or devices but does accomplish what is called CANALITH REPOSITIONING in order to clear otic crystals that have broken within the inner ear and settled onto a membrane within the cochlea stimulating severe bouts of vertigo which may be accompanied by headache when severe.

The difference with BPPV compared to other forms of vertigo that in BPPV the symptoms usually disappear within a very short period of time so long as the head does not change position again after the initial jolt. The fact that you do aerobic exercise daily makes me suspicious for this since this is one of the associated activities that even younger people do associated with this condition (usually seen in the over 55-60 year old patients).

Orthostatic hypotension (OH) or suddenly dropping blood pressure due to medication side effects or dehydration or hypoglycemia can also be a cause of your symptoms. If you were recently placed on medication for cholesterol, blood pressure, or depressive mood disorder and this is roughly around the same time these symptoms started occurring then, your doctor should consider medication interactions or side effects as a possible cause of the symptoms and adjust or eliminate medications accordingly.

Happy health.
Regards

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