Endolymphatic hydrops presumption tests for patients with vestibular migraine

Abstract

Background

The aetiology of vestibular migraine (VM) has not yet been defined; endolymphatic hydrops (EH) has been suggested as a candidate.

Objectives

This study aimed to clarify the relationship between VM and EH using neuro-otological tests, including the EH presumption test.

Materials and methods

Fourteen patients with VM underwent caloric testing, video head impulse test (vHIT), cervical and ocular vestibular evoked myogenic potential (cVEMP and oVEMP), and EH presumption tests such as the Futaki’s test and furosemide loading VEMP.

Results

Caloric testing was abnormal in two of the 14 cases (14.3%), and vHIT was abnormal in one of 12 cases (8.3%). Abnormal asymmetry ratios (ARs) of cVEMP and oVEMP were observed in two of 14 cases (14.3%) and six of 13 cases (46.2%), respectively. Futaki’s test results were positive in five of 14 cases (35.7%). Furosemide loading VEMP was positive in seven of 14 cases (50.0%). Nine patients (64.3%) were positive for at least one EH presumption test.

Conclusions and significance

EH is not a rare finding in VM; however, the ratio is less than that in Meniere’s disease.

Chinese Abstract

背景：前庭性偏头痛（VM）的病因尚未确定；内淋巴水肿(EH) 已被指出是可能的病因。

目的：本研究旨在通过神经耳学测试, 包括 EH 推定测试, 澄清 VM 和 EH 之间的关系。

材料和方法：17 名 VM 患者接受了热量测试、视频头脉冲试验 (vHIT)、颈椎和眼前庭诱发肌源性电位 (cVEMP 和 oVEMP), 以及诸如 Futaki 测试和呋塞米负荷 VEMP测试的 EH 推定试验。

结果：14例中有2例（14.3%）热量测试异常, 12 例中有1例vHIT异常(8.3%)。在14 例中有两例观察到 cVEMP 异常不对称比 (AR) (14.3%), 13 例中有 6 例观察到 oVEMP 异常不对称比 (AR) (46.2%)。 Futaki 的检测结果在14 例中有5例呈阳性（35.7%）。 14 例中有 7 例呋塞米负荷 VEMP 呈阳性 (50.0%) 。九名患者(64.3%) 至少一项 EH 推定测试呈阳性。

结论及意义：内淋巴水肿在前庭性偏头痛患者中并不罕见；但是, 发生比率小于梅尼埃病患者中。

Keywords:

• Vestibular migraine
• endolymphatic hydrops
• furosemide test
• furosemide-loading VEMP

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was supported, in part, by a Grant-in-Aid for Research for Scientific Research(C) from Japan Society for the Promotion of Science(JSPS) (17K11346).