Episodic Coma Due to Acute Basilar Artery Migraine: Correlation of EEG and Brainstem Auditory Evoked Potential Patterns

Abstract

Our patient presented with three episodes of deep coma in 5 weeks, followed by a complete recovery. The neuroradiological tests and spinal fluid analysis excluded structural lesions, including subarachnoid hemorrhage, from the diagnosis. A nonconvulsive status was excluded by 24-hour EEG monitoring. The EEGs and brainstem auditory evoked responses were abnormal during ictus, but they reversed to normal with the clinical recovery. Timely neurophysiological tests helped in the diagnosis of basilar artery migraine.

Migraine-related vertigo: Diagnosis and treatment

“…Potentially, release of these substances could lead to a functional vestibular tone imbalance due to asymmetric activation or deactivation of vestibular neuronal activity. Transient and persisting brainstem dysfunction has been documented with brainstem auditory evoked potentials and positron emission tomography in migraine sufferers [60][61][62].…”

Auditory brainstem response in pediatric migraine: During the attack and asymptomatic period

“…While some authors observed no abnormalities in brainstem responses [23,25,28], others have described some alterations of brainstem functions in migrainours [7,26,27,[29][30][31]. In this study, we aimed to document if any hearing changes were present in children suffering from migraine during or/and between migraine attacks.…”

“…I-V and III-V IPLs were significantly prolonged but not exceed clinical norm Ganji et al [27] A case A basilar artery migraine patient At migraine attack ABR were abnormal during ictus, but they reversed to normal with the clinical recovery Ganji [28] A Drake et al [26] found peak latency and interpeak latency differences in 50 patients. As mentioned above these differences may explain the contradictory results.…”

“…Auditory hallucinations, tinnitus, fluctuating hearing loss, phonophobia and sudden deafness are previously reported auditory symptoms [1,5,6,[18][19][20][21][22]. Because of ABR latency variables seem to be a sensitive measures of auditory dysfunction, hearing parameters in migraine has been studied with ABR in the relevant literature [7,13,[23][24][25][26][27][28][29][30][31]. In Table 6, we summarized findings of the studies which evaluate the auditory alterations of migrainours with ABR.…”

“…By that way they modify the activity of midline structures of brainstem that causes transitory hearing differences. In few investigations, the hearing status have been evaluated during migraine attack [27][28][29][30]. Although the manifestations of migraine initiate in infancy and proceed to late life, auditory system involvement has not been studied by ABR in pediatric age group during attack period.…”