Auditory Manifestations of Vestibular Migraine

Shi, Shengjun; Wang, Dan; Ren, Tongli; Wang, Wuqing

doi:10.3389/fneur.2022.944001

Cited by 21 publications

(24 citation statements)

References 38 publications

(47 reference statements)

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“…Along with vestibular symptoms and migrainous headache, VM patients frequently experience unilateral or bilateral auditory symptoms such as tinnitus (52%), aural fullness (41%), mild and easily reversible low-frequency hearing loss (21%), and even otalgia (8.4%) [50]. However, because of their great incidence in other vestibular disorders, it was decided that auditory symptoms should not be included in the VM diagnostic criteria [5].…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Vestibular Migraine

Ryliškienė¹,

Jokubaitis²

2024

Pain Management - From Acute to Chronic and Beyond

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The consensus diagnostic criteria for vestibular migraine (VM) are used to specifically describe episodic vestibular symptoms associated with migraine. Because of an incomplete understanding of the etiology, a variety of clinical manifestations, and overlap with other vestibular disorders, the precise prevalence of VM is unknown. Clinical examination during vestibular episodes and vestibular laboratory tests interictally are more commonly abnormal in patients with VM than in controls, but none of the findings are specific for the diagnosis. The majority of information about VM treatment originates from case studies and retrospective reviews. In this chapter, the current epidemiology data, pathophysiology, significance of clinical and laboratory findings, and possible therapeutic approaches with existing and new medications or devices will be discussed.

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Section: Clinical Characteristicsmentioning

confidence: 99%

Vestibular Migraine

Ryliškienė¹,

Jokubaitis²

2024

Pain Management - From Acute to Chronic and Beyond

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“… 17 , 18 Auditory disturbances, such as tinnitus, muffled hearing and ear fullness that typically occur in both ears, have also been reported in up to 60% of the patients. 19 …”

Section: Progressmentioning

confidence: 99%

Treating Vestibular Migraine When Pregnant and Postpartum: Progress, Challenges and Innovations

Teelucksingh¹,

Govind²,

Dobson³

et al. 2023

IJWH

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Vestibular migraine is a leading cause of vertigo in pregnancy and, although not a distinct migraine subtype, is an episodic syndrome associated with migraine. Vestibular migraine is associated with diverse symptoms such as vertigo, aura, allodynia, osmophobia, nausea, vomiting and tinnitus, many of which may be exacerbated by, masked or even dismissed in pregnancy. Vestibular migraine is likely an underdiagnosed and undertreated condition in pregnancy. The aetiology of vestibular migraine remains incompletely understood, although various theories have been proposed, including genetic predisposition, neurochemical dysregulation and pro-inflammatory mechanisms, all of which are derived from the pathophysiology of classical migraine. Physiologic changes to the endocrine, haematologic and vascular systems in pregnancy may affect pathophysiological processes in vestibular migraine, and can alter the course of symptoms experienced in pregnancy. These changes also predispose to secondary headache disorders, which may have similar presentations. There has been considerable progress in therapeutic advances in vestibular migraine prophylaxis and treatment outside of pregnancy. There is currently no significant evidence base for acute treatment or prophylaxis for pregnant patients, with treatment recommendations extrapolated from studies on classical migraine, and offered on a benefit versus risk basis. Challenges commonly encountered include difficulty establishing a diagnosis, in addition to recognising and treating neuropsychiatric and gestational co-morbidities. Anxiety, depression, hypertensive disorders and cardiovascular disease are closely associated with migraine, and important contributors to morbidity and mortality during pregnancy. Identifying and treating vestibular migraine during pregnancy offers a unique opportunity to impact future patient health through screening and early treatment of associated co-morbidities. There have been innovations in classical migraine therapy that may confer benefit in vestibular migraine in pregnancy, with emphasis on lifestyle modification, effective prophylaxis, abortive therapies, cognitive behaviour therapy and management of vestibular migraine-related comorbidities.

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“…Vestibular migraine impacts an estimated 1%–2.7% of the population 9–11 and accounts for 25% of patients with vertigo 8 . Median age of vestibular migraine onset is quoted between 30 and 40 years, and women are affected three times more than men 12–14 . Patients who suffer from vestibular migraine are more disabled with lower health‐related quality of life than migraineurs without vestibular symptoms 10,12,15,16 …”

Section: Epidemiology and Effect On Patientsmentioning

confidence: 99%

Migraine management for the otolaryngologist

Brooks

Tawk

Djalilian

et al. 2023

Laryngoscope Investig Oto

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ObjectiveTo characterize migraine pathophysiology, presentation, and current treatment strategies, specifically in regard to vestibulocochlear manifestations of migraine.MethodsNarrative review of available literature.ResultsMigraine disorder can be described as a spectrum of otologic manifestations, with vestibular migraine now recognized with fully‐fledged diagnostic criteria. Otologic manifestations are theorized to be due, in part, to trigeminal innervation of the inner ear structures and calcitonin gene‐related peptide (CGRP) expression within the labyrinth. Patients can experience vertigo, aural fullness, enhanced tinnitus, and hearing loss without the characteristic migraine headache, leading to under recognition of these symptoms as migraine‐related. Meniere's disease, mal de débarquement syndrome, persistent postural perceptual dizziness, and recurrent benign paroxysmal positional vertigo have close associations to migraine and may exist on the migraine spectrum. Migraine treatment consists of two goals: halting acute attacks (abortive therapy) and preventing attacks (prophylactic therapy). Abortive medications include triptans, corticosteroids, anti‐histamines, and anti‐emetics. Pharmacologic prophylaxis in conjunction with lifestyle modifications can decrease frequency and severity of symptoms and include tricyclic antidepressants, calcium channel blockers, anti‐epileptic medications, selective serotonin reuptake inhibitors, serotonin‐norepinephrine reuptake inhibitors, beta‐blockers, gepants, and monoclonal antibodies to CGRP. Promising evidence is emerging regarding the ability of migraine medications to positively treat the various otologic symptoms of migraine.ConclusionMigraine disorder manifesting with primarily cochleovestibular symptoms can be challenging to diagnose and manage for practicing clinicians. Patients with various vestibulopathies that are closely related to migraine may benefit from migraine treatment. Lifestyle choices and prophylactic medications are key to satisfactorily preventing acute migrainous attacks and improve function.

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Auditory Manifestations of Vestibular Migraine

Cited by 21 publications

References 38 publications

Vestibular Migraine

Vestibular Migraine

Treating Vestibular Migraine When Pregnant and Postpartum: Progress, Challenges and Innovations

Migraine management for the otolaryngologist

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