Migraine and audiovestibular dysfunction: is there a correlation?

Purpose: To study the audiovestibular functions in cases of migraine with or without vertigo.

Materials And Methods: This was a prospective study involving 50 cases of migraine who were divided into 2 groups: patients with vertigo and those without. All patients underwent a detailed otological and neurootological examination followed by full audiological and vestibular investigation including pure tone audiometry, speech reception threshold, speech discrimination score, tone decay, short increment sensitivity index, auditory brainstem-evoked responses, and electronystagmography (ENG).

Results: Thirty-eight (76%) of 50 patients had vertigo on presentation, of which rotatory nonpositional vertigo (22/38) was the most common. Phonophobia was the most common auditory symptom (35/50, 70%) followed by tinnitus (25/50, 50%). Only 17 patients (34%) reported hearing loss, of whom only 7 had documented hearing loss on pure tone audiometry. However, the auditory brainstem-evoked responses of all these patients showed some abnormalities in the form of prolonged absolute latency or prolonged interwave peak latencies or both. Electronystagmography revealed canal paresis in 13 patients (26%), although there was no statistical difference between patients with or without vertigo on various electronystagmographic parameters.

Conclusion: Auditory brainstem-evoked response abnormalities may be the earliest indicator of impending auditory involvement in migraine.