It has recently been discovered that branches of the trigeminal nerve that innervates the intracranial blood vessels innervate the tiny blood vessels in the inner ear . We have already seen how this nerve releases peptides in migraine that can cause inflammation of local blood vessels . Interestingly , experiments have shown that electrical stimulation of the trigeminal nerve has caused blood vessels in the inner ear to become “ leaky ” as well . Could it be that this leads to fluid changes in the inner ear , which could affect it severely enough to cause a problem like Meniere ’ s disease ? This is presently speculative , but we find that many patients with migraine and Meniere ’ s disease who are treated effectively for migraine have experienced an improvement in their Meniere ’ s symptoms .
Migraine and Vertigo
Twenty-five percent of migraineurs experience vertigo along with their other migraine symptoms . In many patients seen at our balance clinics , vertigo is the predominant feature of their migraine . We typically find that they have had more classic migraine headaches at some time in the past , or have a family history of migraine . Migraine symptoms of new onset in a patient with no personal or family history of migraine can also occur . This is particularly common after head injury or whiplash with chronic neck symptoms . Neck symptoms and spasm tend to increase weeks to months after an initial whiplash injury , causing headache and associated episodes of vertigo . These symptoms are generally not associated with pressure in the ear or hearing changes and may originate in the brainstem from faulty central processing of balance information from the inner ears . These patients are often best treated with physical therapy to decrease neck muscle stiffness and pain , medications to decrease neck muscle stiffness and pain , as well as traditional migraine therapy .
Migraine and Otalgia ( Ear pain )
Up to 40 % of migraineurs report ear pain that lasts anywhere from seconds to months on end . Ear pain has many causes , including infection and Eustachian tube problems in the ear , TMJ , and referred pain from the extensive lining of the throat . Migraineurs who present to the doctor with ear pains frequently complain that their ears are hypersensitive to touch , to wind , and to cold . When an otolaryngologist has ruled out all of these other causes of ear pain in a patient with a history of migraine , migraine treatment is often effective in eliminating the pain .