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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Migraines

I get migraines pretty often since one of my main triggers is heat, and I also have BPPV. I've noticed that the two seem to feed off of one another once one is triggered. Is there any way to prevent that, or do I need to just rough it out and/or sleep?
Tue, 11 Jul 2017
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Neurologist 's  Response
Hello:

You are right. Migraine can present with vertigo (we call it "Vestibular Migraine"). In children, benign paroxysmal vertigo can be a migraine manifestation. If you are having 4 or more attacks per month, you need prophylactic medication. It can be done with topiramate, amitryptiline, propranolol, semisodium valproate, candesartan, melatonin, magnesium, and some other drugs. It could help you get better diminishing the pain frequency, intensity and duration.

For the acute attacks, you can try some specific migraine drugs as sumatriptan, zolmitriptan, eletriptan. If you have nausea, maybe metoclopramide would help.

Try to write a migraine diary, taking note of your specific triggers, some common triggers are heat (the one you have identified), some odors as cigarette smoke, gasoline; some foods as cured meat, aged cheeses, smoked fishes, alcohol; also fasting, sleep deprivation and, in some patients, movement as in a car ride. Try to avoid them and try to eat healthy and do some exercise. Do not eat sausages or any food containing monosodium glutamate, as they will cause you pain.

I hope this helps. I suggest consulting with a neurologist for a complete assessment. If you have any doubt before your appointment, please let me know.
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Suggest Treatment For Migraines

Hello: You are right. Migraine can present with vertigo (we call it Vestibular Migraine ). In children, benign paroxysmal vertigo can be a migraine manifestation. If you are having 4 or more attacks per month, you need prophylactic medication. It can be done with topiramate, amitryptiline, propranolol, semisodium valproate, candesartan, melatonin, magnesium, and some other drugs. It could help you get better diminishing the pain frequency, intensity and duration. For the acute attacks, you can try some specific migraine drugs as sumatriptan, zolmitriptan, eletriptan. If you have nausea, maybe metoclopramide would help. Try to write a migraine diary, taking note of your specific triggers, some common triggers are heat (the one you have identified), some odors as cigarette smoke, gasoline; some foods as cured meat, aged cheeses, smoked fishes, alcohol; also fasting, sleep deprivation and, in some patients, movement as in a car ride. Try to avoid them and try to eat healthy and do some exercise. Do not eat sausages or any food containing monosodium glutamate, as they will cause you pain. I hope this helps. I suggest consulting with a neurologist for a complete assessment. If you have any doubt before your appointment, please let me know.