HSC Section 8_April 2017

PREVALENCE OF PULSATILE TINNITUS

REFERENCES

We also were unable to control institution of the diet. Patients were given a hand out regarding foods to avoid. Administration and adherence were at the patient’s discretion. It is possible those that did not improve did not follow the diet as was the case in one patient. Even if the patients followed the diet, they may not have improved. Finocchi and Sivori (11) report that only 20% of patients in their study had dietary triggers. A study strength is over 10 years of management with one surgeon providing a consistent treatment approach. It is also an interesting concept to add to the literature, especially in the light of the prevalence of migraine. A necessary next step is a prospective study. Patients with PT, who have definitive imaging to rule out serious pathology, could be randomized to a migraine diet and followed prospectively to determine resolution of symptoms.

1. Mattox DE, Hudgins P. Algorithm for evaluation of pulsatile tinnitus. Acta Otolaryngol 2008;128:427–31. 2. IHS Classification. ICHD-II Migraine. Available at: http://www. ihsclassification.org/en/02_klassifikation/02_teil1/01.00.00_migraine. html. Accessed March 20, 2015. 3. Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: Updated statistics from government health surveillance studies. Headache 2015;55:21–34. 4. Tfelt-Hansen PC. History of migraine with aura and cortical spreading depression from 1941 and onwards. Cephalalgia 2010;30:780–92. 5. Welch KMA, Dandrea G, Tepley N, Barkley G, Ramadan NM. The concept of migraine as a state of central neuronal hyperexcitability. Neurol Clin 1990;8:817–28. 6. Messlinger K, Lennerz JK, Eberhardt M, Fischer MJM. CGRP and NO in the trigeminal system: Mechanisms and role in headache generation. Headache 2012;52:1411–27. 7. Scher AI, Stewart WF, Ricci JA, Lipton RB. Factors associated with the onset and remission of chronic daily headache in a population- based study. Pain 2003;106:81–9. 8. Ohayon MM. Prevalence and risk factors of morning headaches in the general population. Arch Intern Med 2004;164:97–102. 9. Wakerley B, Tan M, Ting E. Idiopathic intracranial hypertension. Cephalalgia 2015;35:248–61. 10. Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 1988;45:875–7. 11. Finocchi C, Sivori G. Food as trigger and aggravating factor of migraine. Neurol Sci 2012;33:S77–80.

CONCLUSION

PT can be observed in the context of migraine. Treat- ment of migraine with diet and medication can possibly lead to resolution of PT. However, the true association between migraine and PT needs to be evaluated with prospective well-controlled studies.

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