Tinnitus in Migraine: An Allodynic Symptom Secondary to Abnormal Cortical Functioning?


  • Michel Volcy MD,

  • Fred D. Sheftell MD,

  • Stewart J. Tepper MD,

  • Alan M. Rapoport MD,

  • Marcelo E. Bigal MD

  • From The New England Center for Headache, Stamford, Connecticut (Drs. Volcy, Sheftell, Tepper, Rapoport, and Bigal); International Headache Society Fellow, 2004, based at The New England Center for Headache, Stamford, Connecticut (Dr. Volcy); Department of Psychiatry, New York Medical College, Valhalla, New York, New York (Dr. Sheftell); Department of Neurology, Yale University School of Medicine, New Haven, Connecticut (Dr. Tepper); Department of Neurology, Columbia University College of Physicians & Surgeons, New York, New York (Dr. Rapoport); and Department of Neurology, Albert Einstein College of Medicine, New York, New York (Dr. Bigal).

Address all correspondence to Dr. Fred Sheftell, The New England Center for Headache, 778 Long Ridge Road, Stamford, CT 06902.


Tinnitus is not a common auditory symptom in migraine. Recent research suggests that central sensitization (CS) develops in most migraneurs during the course of a migraine attack. Herein we describe 3 patients with primary headache disorders and tinnitus as their chief complaint, in whom the tinnitus intensity consistently increased during headache attacks. In headache patients, tinnitus may be related to spontaneous and aberrant neural activity at any level along the auditory axis, with abnormal reorganization processes in the auditory cortex following hearing receptor damage. We hypothesize that the tinnitus intensity increase could be an allodynic symptom related to CS, or alternatively could be associated with cortical hyperexcitability.