Fluctuating hearing losses in children can be migraine equivalents

Fluctuation of hearing thresholds in an already severely to profoundly deaf child constitutes a stressing condition and a therapeutic challenge. Thorough medical inquiries revealed strong histories of migraine headaches in the parents of 13 severely deaf children (mean age: 7 years) and two of them also presented symptoms of migraine. This disease is viewed as a form of a relatively benign cerebral vasospasm causing an intense transitory vasodilatation of the small vessels of the brain and a subsequent sterile inflammatory reaction. Liberation of histamine, serotonin and plasma kinins appear to interfere with the metabolism of nerve cells. All children in our study had suffered from anoxia at birth, a condition related to a depopulation of cochlear brainstem nuclei. Migraines may therefore produce obvious hearing symptoms when vasomotor disturbances occur in already damaged nervous structures. Treatment with propranolol hydrochloride (HCl), a potent beta-blocker, resulted in cessation of hearing fluctuations in all patients and in an improvement of thresholds in two of them. We presented our results, as well as preliminary studies on asphyxiated rats shortly after birth, with transitory artificially induced cerebral vasodilatation.