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Many patients who present to the otolaryngologist have manifestations of migraine that respond to migraine management but do not look like the typical migraine headache physicians and patients are familiar with. Headache may be absent altogether in these patients. We can confirm the diagnosis by recognizing common patterns of symptoms in these patients. 89% report facial pressure of some type, 82% report dizziness, 70% have tinnitus and 62% have ear pressure. These patients frequently have symptoms that have persisted despite other treatments for individual symptoms. All symptoms respond together when the underlying migraine dysfunction is treated with preventive medication and reduction of migraine triggers. For many patients who have been looking for a solution to their problem for years, the discovery that there is a single treatable underlying cause of their illness is transformational. For more information atypical manifestations of migraine see http://www.entad.org/for-patients/patient-information-dr-teixido/migraine-more-than-a-headache/
This patient was placed on a beta blocker and had 75% symptom reduction on first follow up. Only reduced intensity symptoms of dizziness remained, and he experienced many symptom free days.
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