“Great question there. And, the question would be, I can rephrase it to, what if you have both PPPD and vestibular migraine at the same time? So, with PPPD you have constant dizziness. And, PPPD can be triggered by anything that causes vertigo. Vestibular migraine obviously causes vertigo. And, a lot of my vestibular migraine patients, I think at least off the top of my head, over a half of them also have symptoms of PPPD.
And, so what I typically find is treating the migraines by reducing the number of vertigo attacks. That leads to an improvement of the PPPD symptoms as well. In some of the patients, who the PPPD symptoms don’t really get much better or don’t go away, those are the ones I consider sending for vestibular therapy to really help them get back to normal. They tend generally to be those patients who are more anxious, a little bit more prone to distress. That’s what I notice in general.”
Shin Beh, MD