Expert: B. Todd Troost, MD - 2/24/2004

Question
Initial beginning 3 years ago with some lightheadedness and later a one-day vertigo episode; then 6 mo. later diagnosed with tension headaches. Soon headaches were and have been to this day, constant. A year later, and neurologists, chiorpractors, therapists,ENT, audiologist, etc., and drugs (lowest doses of Celexa, neurontin, klonipin, etc. and still headaches, but also made me sick to my stomach)I STILL have the headache and now more vertigo. After two Epley maneuvers and doing the Heilick and some balance therapy, it seems to be worse instead of better. My question: Can I keep getting an Epley (I do love them so... NOT!) or am I stuck feeling like I have a weird head? And, do you feel that my headache (diagnosed tension, with some migraine symptoms) and the vertigo may be related? After three years of this life-altering thing, I'm about at my wits end.

Answer
Dear Karen:

There is an unofficial subtype of migraine, vestibular migraine, that is characterized by episodes of dizziness followed by headache.   Rarely there are just episodes of dizziess without headache.  There are no tests or exam findings that make the diagnosis, it is primarily made by the association of headache with dizziness symptoms.

Most people with dizziness do not have headaches and if your 1 day epidose of vertigo was following six months later with headache - I doubt they are related.

The Epley maneuver is for BPPV ( benign positional paroxysmal vertigo ) but sometimes doesn't work.  Another exercise to try for bppv is the Brandt-Daroff set of home exercises which are descirbed on my website www.ivertigo.net  -  currently the website is down, but should be working within 24 hours.

You also may wish to review headache therapy on my migraine website at:  www.imigraine.net - it should be working tomorrow also.

Best regards,