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Hyung Lee, MD; Gregory T. Whitman, MD; Jeong Geung Lim, MD; Sang Doe Yi, MD; Yong Won Cho, MD; Sarah Ying, MD; Robert W. Baloh, MD

Arch Neurol. 2003;60:113-116.

Background  In case reports, migraine headaches have been associated with fluctuating low-frequency hearing loss and sudden, unilateral hearing loss. Auditory symptoms associated with migrainous infarction have not previously been emphasized.

Objective  To describe migrainous infarction presenting with acute auditory symptoms.

Design  Case reports.

Setting  Tertiary care hospitals.

Patients  A 40-year-old man with a history of migraine suddenly developed bilateral hearing loss associated with severe, throbbing, occipital headache, tinnitus, vertigo, speech disturbance, and right hemiparesis. An early audiogram showed profound, down-sloping, sensorineural-type hearing loss bilaterally. Sixteen days later, a follow-up pure tone audiogram documented marked improvement in both sides to a pure tone average of 30 dB. Right hemiparesis and dysarthria also improved steadily for 2 months. A 25-year-old woman with a history of migraine with aura suddenly developed hyperacusis, unilateral hearing loss, and migraine headache early in migrainous infarction. Magnetic resonance imaging documented infarcts in the pons and cerebellum.

Conclusions  In these patients, acute auditory symptoms are a part of the prodrome of migrainous infarction. We speculate that these symptoms may have resulted from migraine-associated vasospasm. Migrainous infarction should be considered in the differential diagnosis of acute auditory symptoms, including sudden, bilateral hearing loss.

From the Departments of Neurology, Keimyung University, School of Medicine, Daegu, Korea (Drs Lee, Lim, Yi, and Cho), University of California, Irvine College of Medicine, Irvine (Dr Whitman), and University of California, Los Angeles, UCLA School of Medicine (Drs Ying and Baloh).

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