Evaluating Quality of Life in Patients With Meniere’s Disease Treated as Migraine

Ghavami, Yaser; Haidar, Yarah M.; Moshtaghi, Omid; Lin, Harrison W.; Djalilian, Hamid R.

doi:10.1177/0003489418799107

Cited by 28 publications

(42 citation statements)

References 49 publications

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“…Similar benefits from migraine prophylactic regimen have also been demonstrated in other complex otologic disorders such as hyperacusis, vertigo, and Meniere disease. [31][32][33] This may be due to similar underlying vascular pathophysiology between SSNHL and migraine, which is in line with Dogan et al's finding that prophylactic migraine treatment such as topiramate may reduce endothelial pulse wave velocity and also lead to decreased long-term cardiovascular risks. 34 Topiramate's positive role in regulating cerebrovascular autonomic control has also been speculated.…”

Section: Discussionsupporting

confidence: 72%

“…The selected dosages of nortriptyline and topiramate have previously been shown to be both safe and effective for treatment of other otologic conditions. [31][32][33]49,50 However, it is worth noting that these migraine medications have potential side effects that should be considered and monitored. Nortriptyline can cause lightheadedness, whereas topiramate can lead to mild disturbance in taste, appetite, and paresthesia of distal extremities.…”

Section: Discussionmentioning

confidence: 99%

“…The selected dosages of nortriptyline and topiramate have previously been shown to be both safe and effective for treatment of other otologic conditions 31–33,49,50 . However, it is worth noting that these migraine medications have potential side effects that should be considered and monitored.…”

Section: Discussionmentioning

confidence: 99%

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Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

et al. 2020

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Objectives/Hypothesis: To examine the hearing outcomes of patients with sudden sensorineural hearing loss (SSNHL) treated with oral and intratympanic (IT) steroid only or a combination of steroid and migraine treatment. Our hypothesis was that adjuvant migraine medications may improve outcomes in SSNHL. Methods: A retrospective chart review at a tertiary otology center was conducted to identify patients with SSNHL who received oral steroid and IT dexamethasone injection(s) with or without migraine medications (a combination of nortriptyline and topiramate). Results: A total of 47 patients received oral steroid and IT dexamethasone injection(s) only, and 46 patients received oral steroid and IT dexamethasone injection(s) as well as migraine lifestyle changes plus a combination of nortriptyline and topiramate. There were no significant differences in demographics and baseline audiometric data between the two groups. Both groups demonstrated improvements in pure tone average (PTA) and hearing thresholds at 250 Hz and 8000 Hz posttreatment. However, compared to steroid-only group, the adjuvant migraine medications group had significantly greater improvements in hearing thresholds at the lower frequencies (250 Hz, 500 Hz, 1000 Hz). Patients in the latter cohort also had greater improvement in PTA (P = .01) and received fewer IT injections (P = .04) PTA improvement of ≥ 10 dB was observed in 36 patients (78%) in the adjuvant migraine medications group and 22 patients (46%) in the control group (P < .001). Conclusion: In multimodal treatment of SSNHL, supplementing oral and IT steroid with migraine medications may result in greater improvements in lower frequency hearing thresholds and PTA. Furthermore, adjuvant migraine treatment can lead to decrease in number of IT injections, thus reducing procedure-related risks and complications.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

et al. 2020

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“…28 When this sensitization occurs specifically for sound, hyperacusis may be the expected result, particularly in patients with migraine and migraine-related otologic disorders like vestibular migraine and Meniere’s disease. 18,23…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Multi-Modal Migraine Prophylaxis Therapy on Hyperacusis Patients

Abouzari

Tan

Sarna

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: To evaluate the efficacy of a multi-modal migraine prophylaxis therapy for patients with hyperacusis. Methods: In a prospective cohort, patients with hyperacusis were treated with a multi-modal step-wise migraine prophylactic regimen (nortriptyline, verapamil, topiramate, or a combination thereof) as well as lifestyle and dietary modifications. Pre- and post-treatment average loudness discomfort level (LDL), hyperacusis discomfort level measured by a visual analogue scale (VAS), and scores on the modified Khalfa questionnaire for severity of hyperacusis were compared. Results: Twenty-two of the 25 patients (88%) reported subjective resolution of their symptoms following treatment. Post-treatment audiograms showed significant improvement in average LDL from 81.3 ± 3.2 dB to 86.4 ± 2.6 dB ( P < .001), indicating increased sound tolerability. The VAS discomfort level also showed significant improvement from a pre-treatment average of 7.7 ± 1.1 to 3.7 ± 1.6 post-treatment ( P < .001). There was also significant improvement in the average total score on modified Khalfa questionnaire (32.2 ± 3.6 vs 22.0 ± 5.7, P < .001). Conclusions: The majority of patients with hyperacusis demonstrated symptomatic improvement from migraine prophylaxis therapy, as indicated by self-reported and audiometric measures. Our findings indicate that, for some patients, hyperacusis may share a pathophysiologic basis with migraine disorder and may be successfully managed with multimodal migraine prophylaxis therapy.

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“…Ghawany et al [30] treated 25 patients with typical MD following protocol to prophylactic migrainous treatment and showed marked improvement in quality of life in 92% of the patients. He states his results point to etiopathogenetic relation between MD and VM.…”

Section: Hearing Loss During 10 Years Follow-up (N = 19) *mentioning

confidence: 99%

Menière’s Disease: Etiopathogenesis

Oliveira¹

2019

Meniere's Disease [Working Title]

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This chapter will discuss idiopathic Menière's syndrome. That is to say-Menière's disease. We will start with a brief recall on the History of Menière's disease beginning with the description of the syndrome by Prosper Menière in 1861, the description of endolymphatic hydrops in temporal bone studies by Hallpike and Cairns in and by Yamakaua in the same year. Endolymphatic hydrops became a pathologic correlate for Menière's syndrome. Theories that considered endolymphatic hydrops as the cause of the syndrome will be discussed. More recent studies questioning the old theories and thinking of endolymphatic hydrops as an epiphenomenon in the course of the syndrome rather than the cause of the symptoms will be discussed. Temporal bone studies were the basis of these new theories too. Familial Menière's disease will be discussed and several families will be described in detail. Because the phenotype of siblings on each family studied was variable and migraine was present in many affected members of these families a spectrum was postulated going from migraine alone to full blown Menière's disease. Some siblings had what has been described recently as vertiginous migraine and a detailed description of this syndrome will be provided and the differences between this syndrome and Menière's disease will be made clear. About 20% of Menière's disease patients have a familial history. Sporadic Meniere's disease might have a genetic predisposition and other environmental and behavioral factors contribute for the surfacing of the disease (multifactorial etiology). Because migraine is a central phenomenon and the vertiginous episodes and auditory symptoms are peripheral a hypothesis is presented for the pathophysiology of Menière's disease. Recent research comparing vestibular migraine and Manière's disease reinforcing the concept of these syndromes representing a continuum process with similar etiology are discussed at the end.

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Evaluating Quality of Life in Patients With Meniere’s Disease Treated as Migraine

Cited by 28 publications

References 49 publications

Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss

Efficacy of Multi-Modal Migraine Prophylaxis Therapy on Hyperacusis Patients

Menière’s Disease: Etiopathogenesis

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