Hypothetical criteria and types for cochlear migraine.

Cochlear migraine (CM) and cochleovestibular migraine were first reported in 2018. However, the diagnostic criteria and types of CM were still undefined. We proposed a hypothetical criteria for CM as below: A. At least 2 episodes with cochlear symptoms with or without recovery. B. Current or previous history of migraine with or without aura according to the International Classification of Headache Disorders-3. C. One or more migraine features with at least 50% of the cochlear episodes. D. No current or previous history of vestibular symptoms. E. Not better accounted for by another cochlear or International Classification of Headache Disorders-3 diagnosis. Patients who were fitted with all 5 points could be diagnosed as CM. The clinical presentations of 62 adults with CM were included for descriptive and cluster analysis. There were 20 men and 42 women, with an age range of 27 to 72 years (mean, 50 years). 6 patients had migraine with aura, and the other 56 had migraine without aura. 4 types of CM could be categorized by cluster analysis. Type 1: unilateral fluctuating sensorineural hearing loss (SNHL) with or without tinnitus (35.5%). Type 2: repeated idiopathic sudden SNHL with or without tinnitus, with good recovery (22.6%). Type 3: idiopathic sudden SNHL with or without tinnitus, but deteriorated over time (21.0%). Type 4: unilateral fluctuating tinnitus with or without aural fullness, otalgia or mild SNHL (21.0%). We hope to raise more discussion about the criteria and clinical types of CM and/or cochleovestibular migraine.