Cochlear Migraine

Timothy C. Hain, MD• Page last modified: March 8, 2021

You may also be interested in our other pages on migraine on this site

Introduction:

Cochlear migraine is proposed to cause hearing loss in a small number of persons (Lai and Liu, 2018) . It is not an established diagnosis. We have no "cochlear migraine" in the ICD-10 60,000 diagnosis list.

That being said, it is not so easy to establish that migraine itself exists, as migraine has no biomarker and instead depends on "checking off" the right answers on a questionnaire. The International Headache Society publishes periodically a 165 page document attempting to differentiate one type of headache from another. Thus one might say -- why not add another type of migraine to the mix ? But what is the value ?

History:

A large study of sudden hearing loss in Taiwan (Chu et al, 2013), established that in Taiwan, persons diagnosed with migraine, have a modestly higher cumulative risk for sudden hearing loss than normal controls. A much smaller study in Turkey reported in 61 patients that more than expected had migraine.

Mechanism:

It has long been known that the diffuse group of persons with migraine are correlated with other diffuse groups. People with migraine have more dizziness, more hearing loss, etc, than the "normal" population. As Migraine is "all over the place" with respect to mechanism, there is a similar embarassment of potential mechanisms with respect to hearing loss.

Could it be vasospasm ? Cytokines ? Neurotransmitters like serotonin ? Perhaps it is the medications that persons with migraine take that cause vasospasm ? As migraine and Meniere's are linked, perhaps it is just a minor form of Meniere's ?

What do do about this ?

Cochlear migraine is an unprovable hypothesis. You can speculate about it if you want.

References:

  1. Arslan, Y., et al. (2017). "The Etiological Relationship Between Migraine and Sudden Hearing Loss." Otol Neurotol 38(10): 1411-1414.
  2. Chu, C. H., et al. (2013). "Migraine is a risk factor for sudden sensorineural hearing loss: a nationwide population-based study." Cephalalgia 33(2): 80-86.
  3. Lai, J. T. and T. C. Liu (2018). "Proposal for a New Diagnosis for Cochlear Migraine." JAMA Otolaryngol Head Neck Surg 144(3): 185-186.