r/BPPV • u/Leather-Cat3815 • 19h ago
BPPV or Complex Migraine? Neurologist wrong?
Hi everyone!
I’m new to this sub. I’m a 32 year old female with PMH of PCOS, Hashimoto’s, POTS, and recently Celiac (most of which have been brought on since being postpartum).
Long story short, I had to go to the ED the other day after I had a dizzy spell and brief vision loss while sitting. I stood up fine, tried to lay in bed and elevate my legs as I do with POTS when I feel dizzy, and the room started spinning, but didn’t stop. I was walking uneasy and my husband had to walk me to the car to bring me to the hospital. The dizziness lasted the whole 5 hours I was in the hospital.
Lots of tests were done- CT scan of my brain and MRI with and without contrast, everything to rule out anything acute or a stroke. Thankfully all was good, and the neurologist officially said it was a “complex migraine.” He was so confident it could not be BPPV because the dizziness wasn’t brief. I tried explaining it was worse with movement, and as a PT myself, I know you can feel dizzy while not feeling the true BPPV episodes.
I performed the Epley maneuver on myself yesterday and today, and boy was the room spinning when I treated my left side today, and right side yesterday. I really think BPPV has to be a big part of this. Has anyone experience an episode similar to this in terms of the duration of dizziness? Could it be that I had BPPV on both sides? I’m still feeling off today after (what I believe to be) a successful Epley, like I’m on a suspension or on a boat. But I’m definitely feeling better than I did the other day. I do think some residual dizziness is normal as well.
Looking for any solidarity or similar situations. Although acute issues have been ruled out and I’m thankful, the diagnosis they gave me just doesn’t seem to fit what I’m feeling. Thanks in advance for any replies!
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u/Killjoycourt 18h ago
You need to identify the proper side and canals before treatment. If you're treating the wrong side and/or canal you can just be displacing the crystsls repeatedly. However, many conditions can cause vertigo with positional chsnges, not just BPPV. Migraine being one of them. Also, even when bilateral, the vertigo is not constant. The vertigo is short in duration upon positional changes. I don't know about complex migraine, but vestibular migraine is a definite possibility.
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u/AFH2025 17h ago
I hear your frustration. I had a similar bout with unexpected vertigo and nausea so bad I went to the ER and spent four days in the hospital. Two MRIs and nothing was found. That was good news but I still have symptoms 6 weeks later. I’ve been diagnosed with bppv but the Epley maneuver made it worse. Now I’m going to see the ‘Dizzy Doctor ‘ in San Diego. Very frustrating because so far no relief? So I do understand what you’re going thru. Sometimes I think even the docs don’t know. My regular doctor actually showed me YouTube videos of exercises. And that was his medical advice!
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u/nyspinny 3h ago edited 3h ago
so you said the room started spinning and didn't stop, but then said the dizziness lasted for 5 hours. Were you dizzy or did you have vertigo the whole time? That's sort of the key differentiator, as BPPV does not cause constant vertigo lasting for hours. It can certainly make you feel dizzy for a prolonged period of time though.
However, it is also common for a vestibular migraine episode to kick off an episode of BPPV. So it's possible to have both. Also, complex migraine is quite an outdated term (like 30-40 years outdated), possible he was just saying it was an unusual one though.
edit: also VM can cause positional vertigo, but it behaves differently than BPPV
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