Characterising Aural Symptoms in Vestibular Migraine Patients
Abstract
Vestibular migraine is a common neuro-otological condition in which aural symptoms, including tinnitus, aural fullness, sound intolerance, and otalgia, are frequently reported but remain poorly defined and peripheral to diagnostic criteria. Overlap with conditions such as Ménière's disease and Eustachian tube dysfunction adds further clinical uncertainty. This thesis aimed to characterise the aural symptom profile of individuals with probable or definite vestibular migraine, with attention to symptom quality, timing, functional impact, and diagnostic interpretation. Five adult female participants (aged 25–49) completed a pre-interview survey and semi-structured Zoom interview. Survey data-informed diagnostic classification; interview transcripts were analysed using template analysis with a hybrid deductive-inductive approach. Participants described aural symptoms in varied terms and in differing temporal relationships to other vestibular migraine features, with some symptoms preceding episodes, others coinciding with vertigo or headache, and others persisting between attacks. This variability contributed to diagnostic ambiguity, with participants frequently framing their condition in ear-based terms, particularly when headache was absent. Functional consequences included disruption to communication, work, and social participation. Proposed mechanisms, including trigeminovascular activation, central sensitisation, and altered sensory gain, remain inferential in the absence of…
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