Recurrent vestibulopathy: are cVEMP, oVEMP and inner ear MRI useful to distinguish patients with Menière’s disease and vestibular migraine?

Eliezer, Michaël; Toupet, Michel; Housset, Juliette; Houdart, Emmanuel; Hautefort, Charlotte

doi:10.1007/s00405-021-06716-6

Cited by 11 publications

(6 citation statements)

References 45 publications

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“…Patients with definite Ménière disease treated with prophylactic vestibular migraine medications reported improved mental, physical, and social quality of life scores . Further obscuring the symptomatology of Ménière disease and migraine is MRI-demonstrated ELH found in patients with migraine …”

Section: Resultsmentioning

confidence: 99%

“…109 Further obscuring the symptomatology of Ménière disease and migraine is MRI-demonstrated ELH found in patients with migraine. [110][111][112][113] Attempts to differentiate Ménière disease and vestibular migraine using paraclinical tests have not proven successful and low frequency hearing loss remains the hallmark diagnosis of Ménière disease. Vestibular evoked myogenic potentials were used with conflicting results across studies.…”

Section: Is Migraine On the Same Spectrum?mentioning

confidence: 99%

See 1 more Smart Citation

Pathogenesis and Etiology of Ménière Disease

Rizk

Mehta

Qureshi

et al. 2022

JAMA Otolaryngol Head Neck Surg

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Section: Resultsmentioning

confidence: 99%

Section: Is Migraine On the Same Spectrum?mentioning

confidence: 99%

Pathogenesis and Etiology of Ménière Disease

Rizk

Mehta

Qureshi

et al. 2022

JAMA Otolaryngol Head Neck Surg

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“…In the other study, cVEMPs were not different between VM, MD, and RV groups, whereas MD patients had higher oVEMP impairment. Endolymphatic hydrops on MRI was also higher in the MD group [Eliezer et al, 2022].…”

Section: Discussionmentioning

confidence: 81%

Recurrent Vestibulopathy: Comparison of Vestibular Test Results with Ménière’s Disease and Vestibular Migraine

et al. 2022

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Introduction: Recurrent and episodic vestibular symptoms not fulfilling criteria for known episodic vestibular syndromes are named as recurrent vestibulopathy (RV). We aimed to compare the vestibular test results of RV patients with vestibular migraine (VM) and Ménière’s disease (MD). Methods: Twenty patients with MD, 20 patients with VM, 18 patients with RV, and 20 healthy volunteers (HC) were evaluated. Pure-tone hearing thresholds (PTHTs), video head impulse test (vHIT), functional head impulse test (fHIT), and cervical vestibular evoked myogenic potentials (cVEMPs) were studied. Results: PTHT of the MD-affected ears were significantly high, and cVEMP-corrected amplitudes were low when compared with the VM, RV, and HC (p < 0.001 for all). Amplitude asymmetry ratio was significantly high in MD-affected ears when compared with the HC (p = 0.014), VM (p = 0.038), and RV (p = 0.045). VEMP latencies and lateral canal vHIT gain were not different between groups (p > 0.05). The percentage of correctly identified optotypes on fHIT of the MD (p > 0.001), VM (p = 0.004), and RV (p = 0.001) patients were low in comparison with the HC. Conclusion: Apart from hearing loss, low cVEMP amplitudes on the affected side were the main feature in MD differentiating it from VM and RV. Vestibular test results of patients with RV and VM were similar. Low fHIT results in all groups indicate a functional deficit in gaze stabilization. Disabling vertigo attacks disturbing attention may be the cause of this functional impairment. MD, VM, and RV may be parts of a broad-spectrum disorder, RV patients representing milder forms not associated with cochlear or migrainous features.

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“…Therefore, they concluded that inner ear imaging using gadolinium-contrasted MRI was also helpful in differentiating these two clinical disorders [ 31 , 32 ]. However, Eliezer et al [ 33 ] thought that it could be difficult to distinguish between VM and MD at the early stage since EH on MRI is related to the degree of sensorineural hearing loss. The aforementioned findings showed that the results of vestibular function tests or an imaging examination varied and were not specific to MD and VM.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of the Vestibular Autorotation Test in Menière’s Disease, Vestibular Migraine and Menière’s Disease with Migraine

et al. 2022

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(1) Background: Vestibular migraine (VM) and Menière’s disease (MD) share multiple features in terms of clinical presentations and auditory-vestibular functions, and, therefore, more accurate diagnostic tools to distinguish between the two disorders are needed. (2) Methods: The study was of retrospective design and examined the data of 69 MD patients, 79 VM patients and 72 MD with migraine patients. Five vestibular autorotation test (VAT) parameters, i.e., horizontal gain/phase, vertical gain/phase and asymmetry were subjected to logistic regression. The receiver operating characteristic (ROC) curves were generated to determine the accuracy of the different parameters in the differential diagnosis of MD and VM. (3) Results: Our results showed that the horizontal gain of VAT significantly outperformed other parameters in distinguishing MD and VM. In addition, the sensitivity, specificity and accuracy of the horizontal gain were 95.7%, 50.6% and 71.6%, respectively, for the differentiation between VM and MD. In most MD patients, the horizontal gain decreased in the range of 3–4 Hz, while in most VM patients, horizontal gain increased in the range between 2–3 Hz. More MD with migraine patients had an increased horizontal gain when the frequency was less than 5.0 Hz and had a decreased horizontal gain when the frequency was greater than 5.0 Hz. (4) Conclusion: Our study suggested the VAT, especially the horizontal gain, as an indicator, may serve as a sensitive and objective indicator that helps distinguish between MD and VM. Moreover, VAT, due to its non-invasive and all-frequency nature, might be an important part of a test battery.

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Recurrent vestibulopathy: are cVEMP, oVEMP and inner ear MRI useful to distinguish patients with Menière’s disease and vestibular migraine?

Cited by 11 publications

References 45 publications

Pathogenesis and Etiology of Ménière Disease

Pathogenesis and Etiology of Ménière Disease

Recurrent Vestibulopathy: Comparison of Vestibular Test Results with Ménière’s Disease and Vestibular Migraine

Diagnostic Value of the Vestibular Autorotation Test in Menière’s Disease, Vestibular Migraine and Menière’s Disease with Migraine

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