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Otalgia Associated With Migraine

Objective: To investigate the association of otalgia and migraine. Study Design: Retrospective survey with evaluation of otalgia response to migraine treatment. Only patients with minimum symptom duration of 3 months, who accepted migraine treatment and had a minimum follow-up of 3 months, were included. Setting: Single neurotology practice. Subjects: All patients with otalgia in whom other causes of otalgia had been excluded and who were treated with migraine therapies. Intervention: Standard first-line abortive and prophylactic migraine therapies. Main Outcome Measures: Specific clinical data, as well as pretreatment and posttreatment severity scores, were gathered. Response to treatment was assessed by comparing pretreatment and posttreatment symptom scores using paired t test. Results: A total of 26 patients were included. Ninety-two percent responded to migraine therapy with improved symptom frequency, severity, and duration (p < 0.001). Median duration of symptoms was 5 years. Mean delay to response was 2.3 weeks, and mean follow-up was 20 months. Otalgia was the chief complaint in 77%. Pain was dull in 35%, sharp in 19%, throbbing in 19%, and mixed in 27%. Sixty-five percent demonstrated triggerability of otalgia. A total of 65% had International Headache Society migraine. Patients responded to many classes of migraine preventive and abortive medications. Conclusion: Otalgia of unclear cause can be related to migraine mechanisms. Our group showed a high prevalence of migraine characteristics, including headache, migraine-associated symptoms, patterns of triggerability, and response to migraine treatment. Clinical criteria for diagnosis of migraine-associated otalgia are suggested for future prospective study.