Can Migraine Cause Ringing in the Ears?

Ringing in the ears, commonly known as tinnitus, can be associated with several kinds of disorders, including migraine.

Vestibular migraine is a common kind of migraine associated with tinnitus, but there are other kinds of migraine-related attacks associated with tinnitus.

Through proper evaluation and diagnosis, migraine and tinnitus can be treated. Knowing more about this condition can help you recognize symptoms and work with your healthcare team to develop a treatment plan that’s best for you.

Migraine and ear ringing

Vestibular migraine occurs in approximately 1 percent of the population.

Lack of sensory information

Tinnitus may stem from your brain not being able to adapt to a altered sensory information. The brain tries to then compensate for the altered sensory input with more neural activity in the auditory pathway, causing the ringing or buzzing in the ears.

Electric messages

How migraine impacts tinnitus is not definitively known right now. Some studies think it may be spontaneous abnormal neural activity.

In vestibular migraine, one hypothesis is that the cause is abnormal electric messages, causing blood vessels in and around the brain to widen, including the vestibular artery. This affects the inner ear’s balance control system, causing the symptoms.

Precipitating factors

An episode of migraine with tinnitus can sometimes be precipitated by any of the following:

• depression
• anxiety
• trouble sleeping
• higher stress levels

These symptoms can significantly affect quality of life, which makes diagnosis and treatment important.

Other symptoms

In addition to tinnitus, other symptoms that may occur with a vestibular migraine can include:

• severe dizziness
• vertigo
• nausea and vomiting
• lightheadedness
• loss of balance  
• visual disturbances like spots, flashing lights, or blurring

Diagnosis

If you go to a primary care physician with reports of migraine with tinnitus, they will likely refer you to a neurologist. Neurologists are specialists who focus on the nervous system.

What to expect

A specialist will:

• get your medical history
• do a physical exam
• get information on your family history
• discuss your symptoms, including frequency and severity

Diagnostic criteria

The International Headache Society diagnostic criteria for vestibular migraine consist of:

• current or history of migraine
• moderate-to-severe vestibular symptoms, lasting 5 minutes to 72 hours
• half of episodes happen with a migraine attack, visual disturbances, or discomfort with sound or light
• at least five episodes of either vestibular symptoms alone, or with migraine

Ruling out other conditions

They will also rule out other explanations for your symptoms, including medical conditions that may cause tinnitus or migraine.

These can include:

• early signs of hearing loss
• Meniere’s disease
• nerve irritation
• benign positional vertigo (BPV)
• fluid leaks in the inner ear

Your doctor will also ask questions to figure out whether the tinnitus is associated with the migraine or if it’s being caused by something else.

Treatment

Treatment for migraine and ringing in the ears, or vestibular migraine, can include both medications and lifestyle modifications.

Medications can include:

• beta-blockers
• calcium-channel blockers
• tricyclic antidepressants
• serotonin or serotonin norepinephrine reuptake inhibitors (SSRIs or SNRIs)
• topiramate

Medications like benzodiazepines may also be helpful in treating the tinnitus.

Lifestyle modifications that can help migraine include include:

• low-salt diet
• abstaining from caffeine and alcohol
• stress reduction
• white noise machines to reduce the impact of tinnitus on quality of life
• cognitive behavioral therapy

Prevention

Some medications may help prevent migraine with tinnitus. They can also help reduce the risk of having a migraine in the first place.

In addition to the lifestyle changes mentioned above, other modifications that can help prevent migraine include:

• getting enough rest
• staying hydrated
• getting regular exercise
• if your migraines are menstrual-related, taking a water pill and avoiding salty foods

Knowing your triggers can help you modify your behaviors to help avoid future migraines. Keep a journal of what you eat and drink. You may notice a pattern emerging with certain foods that you can avoid in the future.

When to see a professional

Although there is no cure for migraine, there are treatments available. You do not have to live with untreated migraine attacks, especially if you have migraine with tinnitus.

If you have an episode of tinnitus, see a healthcare professional. They can evaluate you for underlying medical conditions that may be causing it, and address it with appropriate treatment.

The bottom line

Migraine and ear ringing, or tinnitus, is not uncommon.

While migraine cannot be cured, there are treatments available that can help prevent migraine and help diminish the tinnitus. This condition can impact quality of life, so prompt diagnosis is important so you can get the appropriate treatment.