Vestibular and auditory manifestations of migraine.
Vestibular and auditory manifestations of migraine.
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DOI：
10.1097/wco.0000000000001024
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发表时间：
2022-02-01
影响因子：
4.8
通讯作者：
Sharon JD
中科院分区：
文献类型：
--
作者：
Benjamin T;Gillard D;Abouzari M;Djalilian HR;Sharon JD
本叙述性评论的目的是讨论有关前庭性偏头痛和其他与偏头痛相关的耳蜗前庭症状的当前文献。前庭性偏头痛影响2.7%的美国人口。误诊是常见的。其病理生理学目前尚不清楚，但新的研究表明，与偏头痛有关的CGRP在听前庭外周表达。最近的一项大规模安慰剂对照试验，旨在观察美托洛尔治疗前庭性偏头痛，由于招募不良而提前终止;然而，在研究完成时，治疗组之间没有差异。许多其他听觉前庭症状已被证明与偏头痛有关，包括耳鸣，听力损失，耳满，耳痛和鼻窦症状。偏头痛还与发展许多耳科疾病的风险相关，包括梅尼埃病、前庭功能丧失、BPPV和突发性感音神经性听力丧失。现在有一些证据表明，患者可能会经历波动性听力损失和耳满，而不伴有与偏头痛相关的眩晕，这被称为耳蜗性偏头痛。偏头痛可引起多种听力和前庭症状，需要进一步研究以了解偏头痛如何影响内耳。
The purpose of this narrative review is to discuss current literature about vestibular migraine and other cochleovestibular symptoms related to migraine. Vestibular migraine affects 2.7% of the United States population. Misdiagnosis is common. The pathophysiology is currently unknown but new research shows that CGRP, which is implicated in migraine headaches, is expressed in the audiovestibular periphery. A recent large-scale placebo controlled trial looking at metoprolol for vestibular migraine was terminated early due to poor recruitment; however, at study completion, no differences were seen between treatment arms. Many other audiovestibular symptoms have been shown to be associated with migraine, including tinnitus, hearing loss, aural fullness, otalgia and sinus symptoms. Migraine is also associated with risk for developing numerous otologic conditions, including Meniere’s disease, vestibular loss, BPPV, and sudden sensorineural hearing loss. There is now some evidence that patients may experience fluctuating hearing loss and aural fullness without vertigo in association with migraine, which is called cochlear migraine. Migraine can cause a variety of audiologic and vestibular symptoms, and further research is required to understand how migraine affects the inner ear.