Because it’s not?
They slap the name “migraine” on this but this is just a diagnosis, not a pathophysiology. The distinction between “diagnosis” and “pathophysiology” is a very important one.
A “diagnosis” does not describe what is wrong with you, it’s just a label for a condition that is usually defined by its symptoms.
Medical science has not determined what is actually going on.
It’s arguably facetious to think that just because there is migraine in the title of the condition that it is actually caused by migraine. I suspect the cause has yet to be determined and a bit more complex. It’s also possible it could be something amiss systemically in the body which manifests in symptoms via the inner ear.
Have you considered the possibility that during the times of poor hearing you actually have bi-lateral endolymphatic hydrops (which is also regularly comorbid with Meniere’s but not exclusive to Meniere’s). This additional pressure may inhibit the vibration of the oval and round windows of the inner ear as well as dampen the hearing sensors responses. To me this is a far more believable and practical explanation than the spaghetti monster of migraine.
I say this time and again, but the fact that MAV sufferers endure positional vertigo proves inner ear involvement in the condition.
This additional pressure might be relieved by the opening of a pressure valve that has found to exist in the inner ears of some animals (Site Trust Level 2 required to view) Perhaps the gates opened for you and this is why your hearing improved. Perhaps it will do this again at some stage? Then again, the fact that they both cleared simultaneously is interesting!
It makes sense that at the time of the valve opening, it would feel like an attack as both the hearing and balance parts of the inner ear would experience a sudden loss in pressure which would definitely make you feel dizzy and possibly even feel like a spin attack.
I’d argue MAV could actually be Secondary Hydrops although they are considered separate diagnoses. It’s interesting how similar the symptoms are between those two and it’s also interesting that you are meant to avoid red wine and cheese with Secondary Hydrops (as with MAV).
Imho pressure regulation of the inner ear is a wholly poorly understood topic in medicine and to me it probably provides the key to solving MAV for good and for many people.
Then again there is vasodilation in migraine and this might be impacting the inner ear. It might even cause a level of hydrops (increased internal pressure of the inner ear)
Without wanting to encourage you to take risks, I’ve often wondered if physical movements might help open the pressure valve by instantaniously increasing the internal pressure enough for the threshold to be high enough for the valve to open? Note the valve, to my knowledge has not been observed in humans but given how we are evolved from animals, there is a big chance it remained in our DNA. These anecdotes help substantiate that idea.