CGRP Receptor Antagonism with Rimegepant as an Acute Intervention for repeated idiopathic sudden sensorineural hearing loss : A Case Report
Abstract
Abstract Objective: To report the novel use of the CGRP receptor antagonist rimegepant for acute treatment of cochlear migraine (CM). Patient Presentation: A 27-year-old woman with a 6-year history of recurrent idiopathic sudden sensorineural hearing loss and migraine symptoms, plus family migraine history, presented with over six acute attacks. Previous therapies (glucocorticoids, Ginkgo biloba, betahistine, hydrochlorothiazide, mannitol) were only partially effective and poorly tolerated. Intervention: A single 75 mg oral dose of rimegepant was administered daily at a fixed time during an acute episode. Outcome Measures: Pure-tone audiometry was performed pre-treatment and on day six. Subjective symptoms (aural fullness, tinnitus) were evaluated. Marked hearing improvement was observed across most frequencies. Complete resolution of aural fullness and significant tinnitus reduction were achieved, resulting in the best hearing thresholds in six years. No adverse events occurred.
Conclusion:: This case supports the concept of cochlear migraine and implicates CGRP in recurrent idiopathic hearing loss, potentially linked to migraine. Rimegepant may offer a targeted, well-toler therapy. Further longitudinal studies are needed to confirm these findings.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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