Expanding the Spectrum of Central Sensitivity Syndrome: Integrating Otologic Migraine as Otologic Central Sensitivity Syndrome

<b>Objective</b>: To propose that migraine-related symptoms such as dizziness, sudden hearing loss, tinnitus, and vertigo-when occurring without headache-should be recognized as manifestations of central sensitivity syndrome (CSS), and to explore the implications of this reclassification for clinical practice and patient care. <b>Data sources</b>: PubMed Central and Google Scholar. <b>Review methods</b>: A search of the literature was performed using PubMed and Google Scholar. Search terms included combinations of keywords such as "migraine", "vertigo", "tinnitus", "dizziness", "sudden hearing loss", "central sensitivity syndrome", and "central sensitization". <b>Conclusions</b>: Non-headache migraine symptoms show significant overlap with characteristics of CSS, including central nervous system hyperexcitability and dysregulation. Neuroimaging and clinical data support this connection, suggesting these symptoms may be better understood within the CSS framework. Recognizing this association could represent a conceptual shift in how such symptoms are classified and managed. <b>Implications for practice</b>: Incorporating non-headache migraine symptoms into the CSS paradigm may lead to earlier recognition, reduce misdiagnosis and stigma, and support the development of more effective, targeted therapeutic strategies for affected patients.