Carl Cincinnato

When we put out the call for topics last year in preparation for the 2019 Migraine World Summit, we were flooded with requests for a world-class expert to discuss all forms of balance-related migraine symptoms, which can be just as debilitating — or even more so — than the migraine condition itself.

Dr. Michael Teixido is an otolaryngologist with a special interest in medical conditions that affect hearing and balance. He participates in many national professional organizations and is a frequent speaker to both professional colleagues and the public. He has taken a leadership role in otolaryngology in education on migraine and benign paroxysmal positional vertigo (BPPV), and he has established teaching tools and foundations to improve patient care. He teaches residents at Thomas Jefferson University of Pennsylvania, and is the director of several medical programs, including the Balance and Mobility Center of Christiana Care.

How can migraine cause balance issues?

Dr. Teixido: “Migraine is a process that involves all parts of the brain, and the networks of neural pathways that control our balance are a part of the brain, which can be affected by migraine.”

How is vestibular migraine diagnosed?

Dr. Teixido: “We don’t have any specific test for vestibular migraine at this time but we recognize it with a high index of clinical suspicion, and by recognizing what we would see as a classic migraine pattern of disease. The typical patient would come to me with a new onset of symptoms of dizziness. And during the same period of months, they may have an increase in headache activity. Now their headaches may not be classic migraine attacks, and they may not even occur at the very same time as their vestibular episodes. But they did come on at the same time. And some of their headaches and some of their vestibular events and symptoms may also come on in response to classic migraine triggers, like weather change, or stress, or fatigue.”

How can people develop better coping skills to handle the isolation and anxiety that comes along with constant dizziness that leads them to be housebound most of the time?

Dr. Teixido: “That’s a terrible problem. This is where you have someone who is functional and active and they may be under an extraordinary amount of stress. Their body is telling them, their brain is telling them that they aren’t able to do that. But now the immobility and the illness has rocked their world so profoundly that there is real despair on top of it. And that grieving is a kind of physiological and psychic stress that just fuels the whole problem and makes it worse. Some patients benefit from counseling, and I always recommend cognitive behavioral therapy because it specifically looks at the way that the patient is thinking about their symptoms. And often they’re catastrophizing or magnifying the impact in a way that doesn’t allow them to have any sort of real rational response. And they can’t get their head around what is happening because they just immediately go to an emotional response. And this, of course, makes their problem worse.”

Watch the full interview to find out:

Why do some people with migraine experience dizziness or balance issues while others do not?
Is it true that you can have migraine without having headache?
Why are individuals with vestibular migraine often misdiagnosed?
What are some of the symptoms that people with vestibular migraine experience?
Do people with vestibular migraine have different triggers than people with migraine in general?
What treatments are available for vestibular migraine?
Is physical therapy or vestibular rehab an alternative treatment available for those with vestibular migraine?
Is diet and lifestyle something that should be considered when living with vestibular migraine?

Watch Dr. Michael Teixido’s interview preview here or order it as part of the Migraine World Summit package from this page.

If you previously purchased the 2019 Migraine World Summit, you are all set to login to watch the full interview.

Posted in: Migraine Education

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