Sensory Dysmodulation in Vestibular Migraine: An Otoacoustic Emission Suppression Study

Objectives/Hypothesis: To seek evidence of sensory dysmodulation in auditory brainstem reflexes in patients with vestibular migraine by studying suppression of otoacoustic emissions (OAEs) by contralateral noise. Study Design: A prospective case-control study. Methods: The authors measured contralateral suppression of OAEs in a group of 33 interictal patients with definite vestibular migraine (migrainous vertigo) according to the strict diagnostic criteria of Neuhauser (2001), and compared them with 31 nonmigrainous controls with matching age and sex distributions. Suppression values were then compared with previously published departmental normative data. In three patients, recordings were compared in the ictal and interictal states. Results: OAE suppression was reduced in 11/33 patients, and 3/31 controls (P = .022 chi(2) test). Binary logistic regression analysis confirmed that the presence of vestibular migraine was significantly associated with abnormal suppression, but no such relationship was seen for symptoms of phonophobia or disease duration. The amplitude of variability between the ictal and interictal state was out of the normal range in 2 out of the 3 patients in whom such recordings were made. Conclusions: These results provide support for the notion of interictal auditory sensory dysmodulation in an as yet unidentified subset of migraineurs with vestibular migraine.