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Prevalence of Pulsatile Tinnitus Among Patients With Migraine
Heather M Weinreich1, John P Carey
1Division of Otology, Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Objective:
To examine the prevalence of pulsatile tinnitus (PT) among patients with a diagnosis of migraine and to determine if treatment of migraine improves symptoms.
Study Design:
Single-institution retrospective patient review.
Setting:
Academic tertiary referral center.
Patients:
Billing data capturing ICD-9 codes 346.xx and 388.3x was used to identify patients with history of migraine and tinnitus. Patients were excluded if the symptom of PT could be attributed to an alternate diagnosis. Data were extracted from the patients' electronic medical records.
Intervention(S):
Therapeutic patients were prescribed a strict migraine diet with or without migraine medication.
Main Outcome Measure(S):
Subjective improvement in tinnitus as documented in electronic medical records.
Results:
One thousand two hundred four patients were identified with an ICD-9 code for migraine and of those patients, 12% (n = 145) had an ICD-9 code for tinnitus. After ruling out alternative causes, the prevalence of PT among all patients with migraine was 1.9%. Of migrainers with PT who underwent migraine treatment, 11 out of 16 reported resolution or improvement of their PT.
Conclusion:
PT can be observed in the context of migraine. Migraine treatment with avoidance of dietary triggers with or without medication can possibly lead to resolution of PT.
Insights
Pulsatile tinnitus (PT) affects 1.9% of migraine patients. Treating the underlying migraine, potentially through diet and medication, may resolve or improve PT symptoms.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Migraine is a common neurological disorder.
- Pulsatile tinnitus (PT) is a rare form of tinnitus.
- The co-occurrence of migraine and PT is not well-established.
Purpose of the Study:
- To determine the prevalence of PT in patients diagnosed with migraine.
- To investigate if migraine treatment impacts PT symptoms.
Main Methods:
- Retrospective review of patient data from an academic tertiary referral center.
- Identification of patients with migraine and tinnitus using ICD-9 codes.
- Exclusion of PT cases with alternative etiologies.
- Analysis of outcomes following migraine-specific dietary interventions and/or medication.
Main Results:
- A total of 1,204 patients with migraine were identified.
- 1.9% of migraine patients were diagnosed with PT after excluding other causes.
- 11 out of 16 patients with PT who received migraine treatment reported improvement or resolution of their tinnitus.
Conclusions:
- Pulsatile tinnitus can be associated with migraine.
- Migraine management, including dietary changes and medication, may offer a potential treatment for associated PT.
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