Vestibular test results in patients with vestibular migraine and Meniere’s Disease

Abstract

Background

Vestibular migraine (VM) and Meniere’s Disease (MD) are episodic vestibular disorders, sometimes difficult to differentiate from each other on clinical grounds.

Objective

To evaluate vestibular test results of the two groups that may help in the differential diagnosis.

Methods

Twenty-two patients with VM, 21 patients with definite MD and 21 healthy volunteers (HC) were studied. Pure tone hearing thresholds (PTHT), cervical vestibular evoked myogenic potentials (cVEMPs), video head impulse test (vHIT) and functional head impulse test (fHIT) were performed.

Results

PTHT of the MD-affected ears were significantly higher than VM and HC groups (p < .001 for both) when cVEMP amplitudes were lower (p = .005 for HC), (p = .006 for VM). Lateral canal vHIT gain of the MD-affected ears were lower than VM patients (p = .003) and the HC (p < .001). The percentage of correctly identified optotypes (CA%) on fHIT was low for both patient groups when compared with the HC (p < .001).

Conclusion

In addition to hearing loss, low cVEMP amplitudes on the affected side with decreased gain on vHIT indicate disturbed saccular and lateral semicircular canal functions in MD patients differentiating them from VM. A functional deficit in gaze stabilization detected by fHIT is the only abnormality found in patients with VM.

Chinese Abstract

背景：前庭偏头痛 (VM) 和美尼尔氏病 (MD) 是发作性前庭疾病, 有时很难在临床上将两者区分开来。

目的：评估两组前庭测试结果, 可能有助于区别诊断。

方法：该研究涉及22 名 VM 患者、21 名明确 MD 患者和 21 名健康志愿者 (HC)。进行了 纯音听阈 (PTHT)、颈前庭诱发肌原性电位(cVEMPs)、视频头脉冲测试 (vHIT) 和功能性头脉冲测试 (fHIT)。

结果：当 cVEMP 振幅较低时（对于 HC, p=.005）, （对于 VM, p=.006）, 受 MD 影响的耳朵的 PTHT 显著高于 VM组 和 HC 组（两组都是p<.001）。受 MD 影响的耳朵的侧耳道 vHIT 增益低于 VM 患者 (p=.003) 和 HC (p<.001)。 fHIT的正确识别视标百分比(CA%)与HC相比, 两个患者组的均较低(p<.001)。

结论：除了听力损失外, 受影响一侧的低 cVEMP 振幅伴随降低的vHIT 增益, 表明 MD 患者的囊状和外侧半规管功能受到干扰, 这将它们与 VM 区分开来。 fHIT 检测到的凝视稳定功能缺陷是发现于 VM 患者的唯一异常。

Keywords:

• Vestibular migraine
• Meniere’s disease
• video head impulse test
• functional head impulse test
• cervical vestibular evoked myogenic potentials

Ethical approval

The study was approved by the ethics committee of Ege University Medical School (Ref. No: E-99166796-050.06.04-57794) and all the patients gave their written informed consent for the procedure.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

Additional information

Funding

No funding