Author(s)
Yaser Ghavami, MD
Jay M. Bhatt, MD
Yarah Haidar, MD
Hossein Mahboubi, MD
Omid Moshtaghi, BS
Harrison W. Lin, MD
Hamid R. Djalilian, MD
Affiliation(s)
Abstract:
Objective: To describe a newly described clinical entity of aural pressure related to migraine and its response to migraine prophylactic therapy and lifestyle changes. Study Design: Retrospective chart review. Setting: Outpatient clinic, tertiary medical center. Intervention: Patients with isolated aural fullness unrelated to Eustachian tube dysfunction were thoroughly evaluated. The patients presented with aural pressure that did not respond to valsalva or a myringotomy and had a negative CT and MR imaging. Patients with a history of episodic vertigo or Meniere disease were excluded. The patients were treated with dietary and lifestyle changes as well as migraine prophylaxis therapy. Results: Eleven patients with over six months of aural pressure were included. There was a predominance of females (82%), with a mean age of 52±13 years. Eight patients (73%) responded to lifestyle and pharmacologic treatment instituted for migraine prophylaxis with complete resolution of symptoms (P value< 0.05). Conclusions: Patients with aural pressure unrelated to Eustachian tube dysfunction, unrelieved with valsalva or myringotomy, and with imaging negative for tumors or canal dehiscence may suffer from a condition related to the migraine spectrum. Such patients will often have a history of migraine headaches or signs and symptoms related to migraine, and often respond well to migraine lifestyle changes and medications used for migraine prophylaxis. Define Professional Practice Gap & Educational Needs: Sometimes there are inconsistencies in diagnosis of patients with aural fullness and clinically these patients may be mistakenly misdiagnosed as other entities such as Meniere's disease or eustachian tube dysfunction, etc. Learning Objective: Describe a newly described clinical entity of aural pressure related to migraine and its response to migraine prophylactic therapy and lifestyle changes. Desired Result: To correctly diagnose patients with migraine-related aural fullness and improving their response to migraine lifestyle changes and medications used for migraine prophylaxis. IRB - Approved