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Hearing symptoms in migrainous infarction
Hyung Lee1, Gregory T Whitman, Jeong Geung Lim
1Department of Neurology, Keimyung University, School of Medicine, Daegu, Korea.
Background:
In case reports, migraine headaches have been associated with fluctuating low-frequency hearing loss and sudden, unilateral hearing loss. Auditory symptoms associated with migrainous infarction have not previously been emphasized.
Objective:
To describe migrainous infarction presenting with acute auditory symptoms.
Design:
Case reports.
Setting:
Tertiary care hospitals.
Patients:
A 40-year-old man with a history of migraine suddenly developed bilateral hearing loss associated with severe, throbbing, occipital headache, tinnitus, vertigo, speech disturbance, and right hemiparesis. An early audiogram showed profound, down-sloping, sensorineural-type hearing loss bilaterally. Sixteen days later, a follow-up pure tone audiogram documented marked improvement in both sides to a pure tone average of 30 dB. Right hemiparesis and dysarthria also improved steadily for 2 months. A 25-year-old woman with a history of migraine with aura suddenly developed hyperacusis, unilateral hearing loss, and migraine headache early in migrainous infarction. Magnetic resonance imaging documented infarcts in the pons and cerebellum.
Conclusions:
In these patients, acute auditory symptoms are a part of the prodrome of migrainous infarction. We speculate that these symptoms may have resulted from migraine-associated vasospasm. Migrainous infarction should be considered in the differential diagnosis of acute auditory symptoms, including sudden, bilateral hearing loss.
Insights
Migrainous infarction can present with acute auditory symptoms like sudden hearing loss. These symptoms may be an early sign of stroke in migraine patients, warranting consideration in differential diagnoses.
Area of Science:
- Neurology
- Otolaryngology
- Neuroscience
Background:
- Migraine headaches have been anecdotally linked to hearing disturbances.
- Auditory symptoms in migrainous infarction have been underemphasized in prior literature.
Observation:
- Two cases of migrainous infarction presenting with acute auditory symptoms are described.
- Patients experienced sudden hearing loss, tinnitus, vertigo, and neurological deficits.
Findings:
- Audiograms revealed sensorineural hearing loss, which significantly improved in one patient.
- Magnetic resonance imaging confirmed infarcts in the pons and cerebellum in one case.
Implications:
- Acute auditory symptoms may serve as a prodrome for migrainous infarction.
- Migraine-associated vasospasm is a potential mechanism for these symptoms.
- Consider migrainous infarction in the differential diagnosis of acute auditory symptoms, including sudden bilateral hearing loss.