Episodic ataxia is genetic and an autosomal dominant disorder characterized by sporadic bouts of ataxia (severe discoordination) with or without myokymia (continuous muscle movement). There are seven types recognised but the majority are due to two recognized entities. People with episodic ataxia have recurrent episodes of poor coordination and balance (ataxia). During these episodes, many people also experience dizziness (vertigo), nausea and vomiting, migraine headaches, blurred or double vision, slurred speech, and ringing in the ears (tinnitus).
Vestibular Migraine is a nervous system problem that causes repeated dizziness (or vertigo) in people who have a history of migraine symptoms. Unlike traditional migraines, you may not always have a headache.
Questions and Answers with Dr. Teixido about Vestibular Migraine
This is an interview with Dr. Teixido done for the Migraine World Summit to be shown in March 2019
How can migraine cause balance issues?
- Can you describe the likely pathophysiology or what at least what we know today? The symptoms of Vestibular Migraine are very variable suggesting many possible sites of dysfunction. It turns out these sites are at the cortex, in the brainstem, and in the inner ear itself.
- Why does vestibular migraine affect some people with migraine but not others? Migraine is a disease with a very variable presentation. Even within the same family. This is because migraine is the consequence of a faulty interaction among many genes (polygenetic), but even with the exact same genes, it is possible for 2 individuals to have very different migraine symptoms. We hear from our vestibular migraine patients all the time that “the rest of my siblings have migraine headaches, but I didn’t get them.” Overall, dizziness is common in migraine; 25% of migraine patients will have vertigo or dizziness at some time. That means about 3 of 100 individuals will experience this problem. That is very common.
- What still don’t we know? We do not yet know which genetic changes predispose some migraine patients to symptoms of dizziness. We do not have a specific diagnostic test to identify these individuals but they can be identified by the pattern of their disease.
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