偏頭痛相關之慢性耳鳴－病例報告

偏頭痛是一種常見的頭痛原因，會引起頭暈、耳鳴或聽障。－56歲女性，苦於無預兆偏頭痛已經5年，因右側耳鳴持續1年多而求診。聽力檢查、複響測試及語音辨識度檢查均為正常，但眼振電圖之視運動性眼振與前庭誘發肌性電位呈現異常。飛行時間效應血管磁振造影顯示基底動脈偏倚及左側顱內椎動脈扭曲，應是反覆偏頭痛發作，使複雜的聽覺皮質功能重整難以恢復原狀，終致右側持續性的耳鳴。經保守治療半年後，偏頭痛發作減少，右側耳鳴消失，經過1年的追蹤，情況依然穩定。
Migraine, a common cause of headache, can lead to dizziness, even tinnitus or hearing blockage. A 56-year-old female has been bothered with migraine without aura for 5 years. She presented right persistent tinnitus for more than one year. Audiometry, recruitment test and speech discrimination score were normal. Time-of-flight magnetic resonance angiogram revealed basilar artery deviation and left intracranial vertebral artery tortuosity. It is probable that auditory cortical reorganization did not recover and so contributed to right tinnitus after frequent migraine headache attacks. Migraine and right tinnitus declined in the following half a year of conservative treatment. In the following one year, it was uneventful.