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International Journal of Pediatric... Jul 2021The objective of this study was to investigate auditory hypersensitivity in WS and to evaluate hyperacusis through standardized protocols, checking if it can be...
OBJECTIVES
The objective of this study was to investigate auditory hypersensitivity in WS and to evaluate hyperacusis through standardized protocols, checking if it can be associated with the absence of acoustic reflexes in people with WS.
METHOD
The study was performed in 17 individuals with WS, aged between seven and 17 years old (10 males and seven females), and 17 individuals with typical development age- and gender-matched to individuals with WS. Statistical tests were used to analyze the responses collected with the Loudness Discomfort Level (LDL) test as well as ipsilateral and contralateral reflex responses.
RESULTS
Auditory hypersensitivity was commonly found. Individuals with WS had phonophobia and were less tolerant to high sound intensity, presenting a reduced discomfort threshold compared to those with typical development. However, hyperacusis was found in 35.29% of individuals with WS and was mild in 50% of cases. There was an association between hyperacusis and acoustic reflex responses, and individuals with absence of the contralateral acoustic reflex were more likely to have hyperacusis.
CONCLUSIONS
Individuals with WS have a high prevalence of auditory hypersensitivity, with the presence of phonophobia; however, hyperacusis was not as prevalent and may be associated with the absence of contralateral acoustic reflexes.
Topics: Acoustic Stimulation; Adolescent; Auditory Threshold; Child; Female; Hearing Tests; Humans; Hyperacusis; Hypersensitivity; Male; Reflex, Acoustic; Williams Syndrome
PubMed: 33965724
DOI: 10.1016/j.ijporl.2021.110740 -
Nursing Standard (Royal College of... Jan 2024Migraine is a common neurological disorder characterised by a severe, pulsating headache, sometimes accompanied with photophobia or phonophobia and nausea and/or...
Migraine is a common neurological disorder characterised by a severe, pulsating headache, sometimes accompanied with photophobia or phonophobia and nausea and/or vomiting. The symptoms of migraine can have a significant adverse effect on a person's ability to undertake normal activities. Nurses have an important role in assisting patients in identifying migraine triggers and in supporting them to manage the symptoms of migraines through lifestyle changes and pharmacological treatments. This article describes different types of migraines and some differential diagnoses and 'red flag' symptoms that could indicate a more serious condition. The author also discusses non-pharmacological and pharmacological management strategies and treatments.
Topics: Humans; Migraine Disorders; Nausea; Vomiting; Photophobia; Hyperacusis
PubMed: 37994154
DOI: 10.7748/ns.2023.e12059 -
Cephalalgia : An International Journal... Aug 2023Clinical trials on anti-calcitonin gene-related peptide monoclonal antibodies poorly investigated their impact on migraine accompanying symptoms.
BACKGROUND
Clinical trials on anti-calcitonin gene-related peptide monoclonal antibodies poorly investigated their impact on migraine accompanying symptoms.
OBJECTIVE
To evaluate the impact of basal accompanying symptoms on anti-CGRP monoclonal antibodies treatment response and their evolution after six months of treatment in migraine patients.
METHODS
Patients with migraine diagnosis seen in the Headache Clinic and treated with erenumab, galcanezumab or fremanezumab were prospectively recruited. They completed a daily eDiary which provided data on headache frequency and the following accompanying symptoms of each day: photophobia, phonophobia, nausea, dizziness, and aura. Patients were classified as responders or non-responders based on 50% or greater reduction in headache days per month at month 6 (≥50% response rate). Accompanying symptoms ratios based on headache days per month were assessed per patient at baseline and after three and six months. Comparisons for basal characteristics, basal accompanying symptoms ratios and their evolution after six months between responders and non-responders were performed.
RESULTS
One hundred and fifty-eight patients were included, 44% (69/158) showed ≥50% response rate after six months. A significant reduction in headache days per month in both groups was found at month 6 (-9.4 days/month in ≥50% response rate group; p < 0.001, -2.2 days/month in <50% response rate group; p = 0.004). Additionally, significant decreases in photophobia (-19.5%, p < 0.001), phonophobia (-12.1%, p = 0.010) and aura ratios (-25.1%, p = 0.008) were found in ≥50% response rate group. No statistically significant reductions were found in nausea and dizziness in any group since their reduction was correlated with the decrease in headache days per month. Higher photophobia ratios at baseline were predictive of an increased response between months 3 and 6 (Incidence Risk Ratio = 0.928, p = 0.040).
CONCLUSIONS
The days per month with photophobia, phonophobia and aura decreased at a higher rate than headache days per month after six months in the ≥50% response group. Higher photophobia ratios were associated with higher response rates between three and six months. It could indicate an involvement of peripheral CGRP in photophobia as well as a central modulation of migraine through these treatments which mainly act on the periphery.
Topics: Humans; Antibodies, Monoclonal; Dizziness; Headache; Hyperacusis; Migraine Disorders; Nausea; Photophobia; Treatment Outcome
PubMed: 37555331
DOI: 10.1177/03331024231177636 -
Cureus Jun 2021Vestibular migraine (VM) is one of the most common types of episodic vertigo. Over the last 11 years, this disorder has been studied by both neurologists and... (Review)
Review
Vestibular migraine (VM) is one of the most common types of episodic vertigo. Over the last 11 years, this disorder has been studied by both neurologists and otolaryngologists. Based on the clinical symptoms and previous migraine history, the Barany Society and the International Classification of Headache Disorders have created the diagnostic criteria for VM. Unilateral and pulsatile headache, phonophobia, photophobia, auras, and a previous history of migraine have been included in these criteria. Although these symptoms are common and widely known, other symptoms not included in the Barany Society criteria are emerging and have been described in some clinical studies. These emerging criteria include audio-vestibular symptoms such as hearing loss, ear fullness, and tinnitus. Ringing ears could be associated with other vestibular disorders such as superior canal dehiscence and Ménière's disease, but not in VM. The frequency, pathophysiological contributors, and clinical characteristics of this symptom in individuals with VM will be explored in this review.
PubMed: 34336489
DOI: 10.7759/cureus.15998 -
Continuum (Minneapolis, Minn.) Apr 2021This article reviews the causes of tinnitus, hyperacusis, and otalgia, as well as hearing loss relevant for clinicians in the field of neurology. (Review)
Review
PURPOSE OF REVIEW
This article reviews the causes of tinnitus, hyperacusis, and otalgia, as well as hearing loss relevant for clinicians in the field of neurology.
RECENT FINDINGS
Important causes of unilateral and bilateral tinnitus are discussed, including those that are treatable or caused by serious structural or vascular causes. Concepts of hyperacusis and misophonia are covered, along with various types of neurologic disorders that can lead to pain in the ear. Hearing loss is common but not always purely otologic.
SUMMARY
Tinnitus and hearing loss are common symptoms that are sometimes related to a primary neurologic disorder. This review, tailored to neurologists who care for patients who may be referred to or encountered in neurology practice, provides information on hearing disorders, how to recognize when a neurologic process may be involved, and when to refer to otolaryngology or other specialists.
Topics: Earache; Hearing Loss; Humans; Hyperacusis; Tinnitus
PubMed: 34351116
DOI: 10.1212/CON.0000000000000961 -
Praxis Apr 2022CME: Idiopathic Intracranial Hypertension Idiopathic intracranial hypertension is a pressure-induced secondary headache disorder and optic neuropathy. It primarily...
CME: Idiopathic Intracranial Hypertension Idiopathic intracranial hypertension is a pressure-induced secondary headache disorder and optic neuropathy. It primarily affects obese women of childbearing age and poses an interdisciplinary challenge both diagnostically and therapeutically. The most common symptom of this disorder are headaches frequently accompanied by photo- and/or phonophobia, whose semiology often resembles that of migraine, followed by transient visual obscurations and pulsatile tinnitus. While protection of visual acuity and visual fields are of first therapeutical priority, adequate headache treatment also plays a key role. In the majority of cases, conservative treatment including weight loss and pharmacological therapy is sufficient. In case of a fulminant disease course or loss of visual function, interventional strategies can be applied additionally. Headache treatment is guided by the predominant semiology.
Topics: Female; Headache; Humans; Intracranial Hypertension; Migraine Disorders; Pseudotumor Cerebri; Vision Disorders; Weight Loss
PubMed: 35414254
DOI: 10.1024/1661-8157/a003838 -
Journal of Clinical Psychology Jul 2019To scope the literature describing misophonia populations, management, and research opportunities. (Review)
Review
OBJECTIVE
To scope the literature describing misophonia populations, management, and research opportunities.
METHOD
Literature searches for research studies describing patients diagnosed with misophonia, defining a patient profile, or outlining development or testing of an intervention for misophonia. A data extraction form was developed and piloted before data from each article were independently charted by two researchers. Researchers then agreed on a final data set for each article.
RESULTS
Thirty-one records were included. The misophonia population was described in terms of onset age, triggers, reaction, coping strategies, and comorbid conditions. We identified nine outcome measures. Case studies on treatments included cognitive behavioral therapy, counterconditioning, mindfulness and acceptance, dialectical behavioral therapy, and pharmaceuticals. Future research priorities identified included clarifying the phenomenology and prevalence of misophonia, and randomized controlled trials of treatments.
CONCLUSION
Misophonia is under-researched but there are strong foundations for future research to finalize diagnostic criteria, validate outcome measures, and trial treatments.
Topics: Cognitive Behavioral Therapy; Female; Humans; Hyperacusis; Outcome Assessment, Health Care; Prevalence
PubMed: 30859581
DOI: 10.1002/jclp.22771 -
The Journal of Laryngology and Otology Apr 2022Described just over 20 years ago, superior semicircular canal dehiscence remains a relatively unknown and easily missed cause of dizziness and auditory symptoms. (Review)
Review
BACKGROUND
Described just over 20 years ago, superior semicircular canal dehiscence remains a relatively unknown and easily missed cause of dizziness and auditory symptoms.
OBJECTIVE
This review focused on the origin, presenting symptoms and underlying pathophysiology of superior semicircular canal dehiscence, and the available treatment options.
MAIN FINDINGS AND CONCLUSION
The bony dehiscence acts as a 'third window', affecting inner-ear homeostasis, and resulting in hypersensitivity and a vestibular response to lower sound level stimuli. The third window effect explains the pressure- and sound-induced vertigo, oscillopsia, and nystagmus, as well as autophony, conductive hyperacusis and tinnitus. The origin of superior semicircular canal dehiscence is linked to the combination of a congenital or developmental factor, and a 'second event' like head trauma, rapid pressure changes or age-related factors. Computed tomography of the temporal bone and reduced vestibular-evoked myogenic potential thresholds can confirm the diagnosis. Despite only retrospective cohorts, surgery is considered a safe treatment option, targeting mainly vestibular but also auditory symptoms, with transmastoid approaches gaining popularity.
Topics: Humans; Nystagmus, Pathologic; Retrospective Studies; Semicircular Canal Dehiscence; Semicircular Canals; Vertigo
PubMed: 34615564
DOI: 10.1017/S0022215121002826 -
Hearing Research Dec 2022Hyperacusis is a debilitating loudness intolerance disorder that can evoke annoyance, fear and aural facial pain. Although the auditory system seems to be the "central"... (Review)
Review
Hyperacusis is a debilitating loudness intolerance disorder that can evoke annoyance, fear and aural facial pain. Although the auditory system seems to be the "central" player, hyperacusis is linked to more than twenty non-auditory medical disorders such as Williams syndrome, autism spectrum disorder, fibromyalgia, migraine, head trauma, lupus and acoustic shock syndrome. Neural models suggest that some forms of hyperacusis may result from enhanced central gain, a process by which neural signals from a damaged cochlea are progressively amplified as activity ascends rostrally through the classical auditory pathway as well as other non-auditory regions of the brain involved in emotions, memory and stress. Imaging studies have begun to reveal the extended neural networks and patterns of functional connectivity in the brain that enrich sounds with negative attributes that can make listening unbearable and even painful. The development of animal models of hyperacusis have enabled researcher to begin to critically evaluate the biological bases of hyperacusis, identify therapies to ameliorate the symptoms and gain a better understanding of the neural mechanisms involved in loudness coding in normal and hearing impaired subjects.
Topics: Animals; Hyperacusis; Autism Spectrum Disorder; Fear; Pain; Emotions
PubMed: 36395696
DOI: 10.1016/j.heares.2022.108648