Chronic Migraines: Dizziness, Blurred Vision, and Nausea

Migraine, dizziness, blurred vision, and nausea?

Hello Doctor: I have been experiencing these symptoms for a long time.
I have difficulty sleeping well every night and find it hard to fall asleep.
It all started about four years ago when I suddenly began to feel headaches that came in waves.
After that, I started to feel dizzy, and when I walked, I felt unsteady and faint.
Suddenly, my limbs would feel weak, and I couldn't get up at all.
Although I was fully aware, I couldn't exert any strength or stand up; I would collapse on the ground and needed assistance to get up.
I went to the hospital for examinations, received IV fluids, and visited both the ENT and neurology departments, but they all said there was nothing wrong.
After taking some medication, I felt a bit better, but recently, in the past year, the symptoms have returned.
Although I haven't reached the point of complete limb weakness, I am still experiencing headaches, dizziness, and now blurred vision.
I have trouble seeing clearly, and after being dizzy for a while, I feel nauseous and have even vomited in the bathroom.
Occasionally, I also experience tinnitus, making it difficult to ride my motorcycle and go to work.
However, my daily routine is normal, my diet is fine, and my stress levels are manageable.
The only issue is that I really struggle to fall asleep at night and have frequent dreams.
This continues to be the case.
Could you please advise me on what to do? Thank you.

fysp, 20~29 year old female. Ask Date: 2013/03/28

Dr. Song Chengxian reply Psychiatry

Hello, due to the complexity and variety of symptoms you are experiencing, I recommend that you visit a comprehensive hospital that has departments of neurology, otolaryngology, and psychiatry.
After evaluations by both the neurology and otolaryngology departments to rule out any related physiological factors, it would be appropriate to refer you to the psychiatry department within the same hospital for further assessment.
This way, the physicians will have better access to the tests and clinical judgments made by other specialists, leading to a more accurate diagnosis.
Wishing you a speedy recovery.
Sincerely, Dr.
Song.

Reply Date: 2013/03/28

More Info

Chronic migraines can be a debilitating condition that significantly impacts daily life, as you have described. The symptoms you are experiencing—dizziness, blurred vision, nausea, and episodes of weakness—are indeed common in individuals suffering from migraines, particularly chronic migraines. Let's break down your symptoms and discuss potential management strategies.

Understanding Your Symptoms
1. Headaches and Migraines: Migraines are often characterized by severe, throbbing headaches that can last from a few hours to several days. They can be accompanied by nausea, vomiting, and sensitivity to light and sound. The fact that you experience dizziness and blurred vision suggests that your migraines may be accompanied by aura, which can include visual disturbances.

2. Dizziness and Weakness: The episodes of dizziness and weakness you describe could be related to migraine-associated vertigo or vestibular migraines. These types of migraines can cause balance issues and a sensation of spinning or dizziness, which can be exacerbated by physical activity or sudden movements.

3. Nausea and Vomiting: Nausea is a common symptom of migraines, and in severe cases, it can lead to vomiting. This can be particularly distressing and may contribute to dehydration and further fatigue.

4. Sleep Disturbances: Difficulty sleeping and experiencing vivid dreams can also be linked to migraines. Poor sleep can exacerbate migraine frequency and intensity, creating a vicious cycle.

Potential Causes
While you mentioned that you have undergone various tests and consultations with ENT and neurology specialists, it’s important to consider that migraines can sometimes be triggered or worsened by factors such as:
- Stress and Anxiety: Even if you feel your stress levels are manageable, underlying anxiety can contribute to migraine frequency.

- Dietary Triggers: Certain foods, caffeine, and alcohol can trigger migraines in some individuals.

- Hormonal Changes: For some, hormonal fluctuations can play a significant role in migraine patterns.

- Sleep Quality: Poor sleep quality can lead to increased migraine frequency.

Management Strategies
1. Medication: Since you have already tried some medications, it may be worth discussing with your healthcare provider about preventive medications specifically for chronic migraines. These can include beta-blockers, antidepressants, or anticonvulsants. Additionally, acute treatments like triptans or anti-nausea medications can be beneficial during migraine attacks.

2. Lifestyle Modifications:
- Sleep Hygiene: Establish a regular sleep schedule, create a restful environment, and avoid screens before bedtime to improve sleep quality.

- Dietary Adjustments: Keep a food diary to identify potential dietary triggers and avoid them.

- Hydration: Ensure you are drinking enough water throughout the day, as dehydration can worsen headaches.

- Regular Exercise: Engage in regular, moderate exercise, which can help reduce the frequency and severity of migraines.

3. Stress Management: Techniques such as mindfulness, yoga, or cognitive behavioral therapy (CBT) can help manage stress and anxiety, which may contribute to migraine episodes.

4. Regular Follow-ups: Since your symptoms have recurred, it’s essential to maintain regular follow-ups with your healthcare provider. They may consider adjusting your treatment plan based on your current symptoms and their severity.

5. Alternative Therapies: Some individuals find relief through acupuncture, biofeedback, or chiropractic care. These can be considered as adjunct therapies.

Conclusion
Chronic migraines can be complex and multifaceted, requiring a comprehensive approach to management. It’s crucial to work closely with your healthcare provider to tailor a treatment plan that addresses your specific symptoms and triggers. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention. Remember, you are not alone in this, and with the right strategies, it is possible to manage your migraines effectively.

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