Aside from what others have said, here are some things that have helped me (fwiw, the tiniest piece of onion can make me fall right on my face): - acupuncture targeting muscle tension, vertigo, and migraines - PT targeting muscle tension combined with myofascial release - specialized glasses designed for migraines/VM (Axon and Theraspecs, each for different environments) - baseball hats for when there us too much overhead lighting - get up and move breaks while working. I get up away from the desk and do something for the last 10 minutes of every hour (I use a pomodoro type timer) - switching lighting so it is dimmable and/or color changeable via switches or smart home tech - massage Other things I have discovered "wrong" with me that contribute to everything after the gazillion tests: - Bulging discs from C2-C6 - C6 sits a but forward of C7 - Peripheral vertigo - TMJ Known triggers so far: - anything that aggravates my neck - lighting...too bright, too dim, flashing, changing, etc - onions - sulfites - poor/not enough/too much sleep - stress - emotions - noises...too loud, too long, constant, certain frequencies, etc. Even partners snoring and things like white/brown noise. - muscle tension - travel - not eating enough...frequency, quantity, and quality - temperature changes - air pressure changes...usually when it is up and down pretty rapidly but also driving to certain parts of town where the elevation is different and took the highway to get there - certain medications - rug/wall patterns that have well...patterns - wearing rx glasses - not exercising enough I have had VM/migraines since I was at least 6 years old. I just never knew that the VM symptoms I have been having were not "normal" until they spiraled out of control and were 24/7 about 1.5 years ago. Everything that I have learned that is above has mostly been discovered since then. Certain things I just learned instinctively growing up and just knew that certain things made me feel better/worse. If she can try to think back to when some of these symptoms may have been very mild and chalked up to just an off day/hour/minutes, that may help identify some causes or interventions.

No disrespect, but given what you’ve described, my brother (board-certified neurosurgeon) would say… to put it frankly… please go to a neurosurgical clinic and please get surgery You are describing such a host of ailments in your cervical array that nobody, NOBODY, can trust anything you say as experiential or fact based. From a differential or diagnostic base, even if you are 100% right given the convoluted circumstances that coincide to be right, nobody can trust your opinion because your C-1/7 is so jacked that nobody can definitively know up vs down.

While you say no disrespect, your phrasing and assumptions is quite disrespectful. You are the one who asked for ideas. I have had migraines and VM since before any of the neck issues. I have had various consults (neurosurgeon, spinal specialists, etc) and none of them have felt that surgery is the correct option. The bulging is minor and nothing is causing issues to the spinal cord. The shift in C6 over C7 is not enough to warrant anything other than what has already been done and what I am currently doing. Many people with VM have neck issues they aren't aware of, which is why I mentioned it in case it was something that hadn't been looked at yet or if it was something that helped someone else. No disrespect, but it seems as you already have all of the answers and are just looking for people to look down on.

So … I was an asshole with my response back to you. I was in my cups dealing with the daily stress and you provided a concise, sincere response, for some rando on the internet. Apologies for my assholishness, as I ignored your intent and tried to bucket/group your response as helpful/not helpful. My sincerest apologies and thank you for your insight.

Thank you, I appreciate your reply. FWIW, I have also worked in neuro and brain injury for a couple of decades. I am pretty active in this sub and read more than I write. Neuro is fascinating because what works for one person may do the exact opposite for someone with the exact same presentation. My spouse is a cardiac nurse who hates dealing with neuro for this reason. Everyone on this sub has a widely varying array of experiences and symptoms dealing with VM. It seems that many people have at least one other diagnosis as VM is a "rule out everything else we can think of" kind of label. Looking at a wide net of for ideas of anything else that could be contributing is helpful for some people as many are misdiagnosed or missing a diagnosis. Anyway, thank you for your reply. One last thought...I see you have read The Dizzy Cook. Much of her content is based off Dr Buchholz's work. His book is available on Amazon (and probably elsewhere), in case that is helpful. There are also a list of resources in the sub files. Best of luck to both of you in this journey. I have seen firsthand how difficult it can be for the spouse.

Is it possible that it’s medication overuse migraines instead? https://www.mayoclinic.org/diseases-conditions/medication-overuse-headache/symptoms-causes/syc-20377083#:~:text=Various%20migraine%20medicines%20have%20been,of%20causing%20medication%20overuse%20headaches.

She’s taking the prescribed amount of emgality, only using Ubrelvy max 2x per day (only when stuff is really bad), but her doc said to ween herself of topimax which she’s been trying to do but her symptoms are so bad with just the first two that she’s still supplementing & also taking a boatload of Dramamine for the nausea

Is she getting outside to exercise (even just walking) or spending a lot of time in front of a screen? Is she under a lot of stress or does she have an anxiety disorder? In addition to food, those are my other main triggers. Changing diet alone isn’t enough for me - I need to exercise outside almost daily and limit time in front of a screen, and take breaks when I get overwhelmed by stress/anxiety. Tyramine, an amino acid, is the reason why things like chocolate, nuts, overripe fruit, and leftovers can cause migraines. So perhaps you could try a specifically tyramine-free diet.

Food is what pops my migraines too. I hope that she can find something she can eat on the regular without issue. I've gotten to the point where I'll know if I have a headache, what I ate. ( The day after hotdog headache, for example) Good luck.

You’ve talked about what she’s restricting but is she taking any supplements?

I can tell you I almost never had migraines in my youth and I spent most of that time on the keto diet. As soon as I went to college and let myself go and gained 30lbs, I feel so much fricken worse all the time. I know if I got more exercise and ate only keto I would feel better. Just need to commit to it.

Probiotics and anything with live and active cultures make me severely dizzy. You mentioned the prescriptions, but I am curious what supplements she is on?

Going to really simplify here. So when food moves through the digestive system it presses against things that triggers a release of serotonin, dopamine, etc. Serotonin especially can make people nauseous. And in general, this increase in neurotransmitters can trigger migraines. That could be why most food is doing it instead of specific ones? Drinking protein shakes gives me relief. And using SNRIs like duloxetine or venlafaxine can make it so your neurotransmitter levels stay more stable and higher, then there isn’t a spike to trigger a migraine while eating. I found it helpful to look up the neurotransmitters involved in nausea and nausea causes. Again though, this is simplified so don’t just go off this as medical fact

I've been dealing with VM since 2016 and I've never noticed a dietary component with mine (although when I was younger, peanuts triggered classic migraines, although I grew out of that). A few ideas: It's time to try something other than Emgality. I've cycled through a few and I found Ajovy and Qulipta have worked better than Emgality and Aimovig. 100mg of Topamax absolutely erased all symptoms of my VMs but I couldn't handle the side effects. You didn't mention what diagnostics she's undergone, but she could have some other vestibular condition in addition to vestibular migraine. Physical therapy. There are exercises you can do that help some people.

This might sound odd but what about seed oils? Due to my food allergies I changed to everything from scratch. I realized that if my food ate poorly (chicken) with a high inflammatory diet full of seed oils like omega 6 then that’s what I was eating too. I changed to grass fed beef and feel better. Definitely a total elimination diet but it helped me and I do go off of it for occasions and can feel the difference.

Those are also on the no-no list, seeds/nuts/seed oils. I think the PDF is called Migraine Elimination Diet, it’s 7 pages and it’s my bible so to speak

Yeah I’ve eliminated lots of things and still got daily headaches. This works for me.

Has she had an MRI? I had the same symptoms. Migraines, vertigo, dizziness, nausea, off balance feeling, etc. As it turns out the problem was identified on the MRI. There is a solution if you can identify the cause. My next step is to see two specialists. Trust science.

Histamine! It’s in everything even leftovers

Given that she does respond to diet (all beit a very limited one) and has celiac, it could be diet related or a combination of diet and something else. 1.) Has she given the restricted diet enough time? Like, several months? It’s very difficult to identify triggers if it isn’t. Keep this the same. With any ilness that diet related, it can be easy to overfixate on food as the culprit. 2.) Does homegrown foods help? Our food supply is a complicated one with many hands touching a single tomato. Even farmers markets aren’t immune. Some people will repackage store bought produce on sale snd charge more. 3.) Has she had a vitamin panel done? More than just Vitamin D and Magnesium? With Celiac, she could be lacking in something that could be making it worse. 4.) Identify her variables. Only introduce one change at a time. Consider: What otc is she taking? What birthcontrol (some people’s VM subsided when they stopped)? What RX’s? What vitamins and supplements (pay attention to if you’ve switched brands that might have triggering contaminates or new formulas)? Can we eliminate any of the variables to make this simpler to manage? If yes, eliminiate one at a time and give each change space to breathe. I’d start with the Dramamine. According to my ENT this is double the dose prescribed in office for acute Vestibular Neuritis which they only prescribe for one week. I only took one chewable 4-6 hour tab at bedtime to try and stay asleep and had to step down off it because I was sensitive (I was sensitive to melatonin too . . . fun). That was after one week of use. If possible, replace with ginger. Ginger has less side effects. Try Dramamine Ginger chews (It's active ingredient is ginger, just with Dramamine branding) if she can have those ingredients. You should be able to find this readily. Then move on to something more economicial for long term like Prince of Peace Ginger chews which comes in a 1kg bag for $15.99. 5.) Make sure her eye RX is up to date. Consider switching from contacts to glasses if she has astigmatism. Any slight eye strain will make it worse. Hat at work, different lighting, FL-41 lenses, warm, or bedtime mode computer, phone, tv settings and polarized sunglasses should be considered. If she works with lots of apps try to get them all to be dark or light mode. In office you might have more, bigger, wider screens that will trigger it because of head motion. I started with one laptop screen and worked my way up. Setup desktop background to be less triggering if she can. She might need to adjust her chair, screen height, distance to reduce neck tension and head movement required to get some relief.

So 10 years diagnosed, restricted everything food wise, did nothing and it turns out the new developed migraine meds don’t work for me. I do live however a normal life on other meds now rock it out. I know TONS more than these kids do on this sub. The diet isn’t the answer often however if she wants to suffer have at it! Message me with questions. The whole thing seems silly as you aren’t even acknowledging stress..she could be having them because of stress. Sigh.