Oscillucusis and sudden deafness in a migraine patient

Abstract

-Migraine is a complex disease that includes neurologic, gastrointestinal and autonomic symptoms, although headache is most common feature. In a portion of cases headache is preceded by focal neurologic symptoms termed auras. Auditory symptoms only rarely occur as part of an aura. We describe a patient whose 13-year migraine history that included the abnormal perception an oscillation of the intensity of ambient sounds (oscillucusis). During a migraine attack immediately after oscillucusis, the patient developed acute and permanent sudden deafness. Clinical and neurologic examinations revealed only profound hearing loss in her left ear. Audiometric testing confirmed the sensorineural nature of the hearing loss. The clinical aspects and physiopathology of auditory symptoms in this case and in patients with migraine is reviewed.KEY WORDS: aura, headache, migraine, oscillucusis, sudden deafness.Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea.RESUMO -Migrânea é desordem complexa que inclui sintomas neurológicos, gastrointestinais e autonômicos, na qual a cefaléia é o achado predominante. Em uma parcela de pacientes o quadro álgico pode ser antecipado por sinais neurológicos focais conhecidos como aura. Descrevemos um paciente que iniciou sua historia de migrânea acompanhada por sensações de flutuações nos sons ambientes (oscillucusis) por treze anos. Durante uma crise de cefaléia imediatamente após a oscillucusia o paciente desenvolveu um quadro agudo e permanente de perda auditiva. Exames clínicos e neurológicos revelaram somente uma perda profunda da audição em ouvido esquerdo, cuja natureza sensorioneural foi confirmada por uma avaliação audiométrica. Os aspectos clinicos e fisiopatológicos dos sintomas auditivos encontrados neste caso e em pacientes com migrânea com aura são revisados e comentados. PALAVRAS-CHAVE: aura, cefaléia, migrânea, oscilucusia, perda súbita de audição. , the focal neurological phenomena that precede or accompany an attack are known as aura. These neurological manifestations include visual, somato-sensory, olfactory and less frequently auditory symptoms.The case of a migraine patient with auditory aura followed by hearing loss is revised, and the literature about auditory symptoms in migraine with aura patients are reviewed. CASEA 56-year-old woman started to present migraine episodes at age 40. An year later she perceived ambient sounds to be fluctuating in intensity (oscillucusis). This would last 50 minutes, and was followed by a unilateral (right or left side), throbbing headache associated with nausea and vomiting. These episodes lasted 18 hours, occurred at twice a month and were commonly triggered by stress. At age 53, she had the sudden onset of profound hearing loss in her left ear that was unassociated with vertigo or any other neuro...

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

“…The previously described auditory manifestations of migraine are fluctuating low-frequency hearing loss, sudden deafness, auditory hallucinations, tinnitus, and phonophobia [1,5,6]. Psychophysical discomfort threshold to sound stimuli is decreased in migraineurs compared with healthy controls, and various electrophysiological abnormalities have been obtained at interictal period [7].…”

“…It may start in infancy and proceed to late life [1]. Neurological manifestations include somatosensory, visual, olfactory, and vestibulocochlear …”

“…As both studies were reported by same author, the possible observer bias affecting the results could be eliminated. Piovesan et al [1] reported dominant unilateral auditory involvement in migraine patients. They found onset of hearing loss only on the left side or more dominant on the left side in right-handed migraine patients [1].…”

“…Piovesan et al [1] reported dominant unilateral auditory involvement in migraine patients. They found onset of hearing loss only on the left side or more dominant on the left side in right-handed migraine patients [1]. Additionally, Bussone et al [25] and Schlake et al [30] also showed inter-ear asymmetries of IPLs and PLs in migraine patients.…”

“…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].…”