Meniere’s Disease and Vestibular Migraine: Updates and Review of the Literature

Abstract

The diagnosis of Meniere’s disease (MD) and vestibular migraine (VM) is primarily based on clinical criteria and their differentiation is often difficult. Currently, there are no known definitive diagnostic tests that can reliably distinguish the two conditions. Patients with MD and patients with VM are treated differently, therefore improving the diagnosis of these two pathologies should avoid errors in management. A systematic review was conducted according to PRISMA guidelines. Medline-Ovid and Embase databases were used to conduct a thorough search of English-language publications dating from 1948 to March 2016. The primary search objective was to identify all papers explicitly comparing MD and VM in order to clarify and validate the diagnosis of these two diseases. A total of 13 articles out of 831 were reviewed. Among other differences, MD showed later age of onset, more hearing loss, tinnitus, aural fullness, abnormal nystagmus, abnormal caloric testing results, abnormal vestibular evoked myogenic potential and endolymphatic hydrops. VM showed more headaches, photophobia, vomiting and aura. Even though differences were noted between the two diseases, only one study focused on assessing the differences between VM, MD and patients fulfilling both diagnostic criteria (MDVM). This study showed no difference between the three groups. Since the introduction of the new International Headache Society and Barany Society criteria for VM, no studies have focused on comparing these three groups. We strongly encourage authors to focus on comparing MD and VM from MDVM in future studies to help adequately distinguish the diagnosis of both diseases.

Association between Ménière’s disease and vestibular migraine

“…Furthermore, the results indicate that migraine increases the severity of MD. In this line our results support those as reviewed by Tabet and Saliba [17] and by Phillips et al [14]. The diagnostic criteria for VM were the product of an accord between the classification committees of the IHS and the Bárány Society for classification of VM [46] that would match with the MD classification of the Bárány Society Committee [6].…”

“…Nevertheless, there is still a concern in the scientific community about the relevance of VM classification as an independent disorder [14]. So far there is a limited number of studies in which the classification between MD and VM are based on statistical work up [17]. Most studies either describe the association of migraine with vertigo, or of vertigo with migraine.…”

“…Hitherto, there are no objective measurements confirming or rejecting the diagnosis of VM from inner ear disease causing vertigo and dizziness as MD (for review See -Tabet and Saliba [17]). Therefore, researchers have tried to show that migraine is a likely cause of vertigo or dizziness by using two approaches.…”

“…Vestibular symptoms in VM have been reported to occur before the headache in a pattern similar to an aura, during the headache, but also completely independent of the headache [22]. In a review, Tabet and Saliba [17] evaluated published research dealing with MD and migraine to study the association of MD with VM. Unfortunately, there is much overlapping with regard to symptomatology for these two conditions, thus creating diagnostic uncertainty.…”

Conservative Treatment Possibilities of Ménière Disease, Involving Vertigo Diaries

“…2 Migraine is the most common differential diagnosis and should be thoroughly checked and excluded in every patient with MD. 3,4 It is difficult to estimate the real figures of MD, the literature reports about a prevalence of around 3.5 to 513/100 000, depending on the geographical location. 5 A strong dominance of females is presented in MD, just like in the other peripheral vestibular disorders.…”