ORIGINAL ARTICLE
MENIERE’S DISEASE AND MIGRAINOUS VERTIGO: COULD WE DIFFERENTIATE THOSE USING OTONEUROLOGIC TESTS?
 
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1
Department of Otorhinolaryngology, Head and Neck Surgery, Naval Hospital of Athens, Athens, Greece
2
2nd University Department of Otorhinolaryngology, Head and Neck Surgery, “ATTIKON” Hospital, Athens, Greece
CORRESPONDING AUTHOR
Panagiotis Gerbesiotis   

Panagiotis Gerbesiotis, Department of Otorhinolaryngology, Head and Neck Surgery, Naval Hospital of Athens, 70 Deinokratous str., Postal code: 11521, Athens, Greece, mobile: +306936614580, Hospital tel.: +302107261114, Hospital telefax number: +302107261175, e-mail: pgerbesiotis@yahoo.com
Publication date: 2013-09-30
 
J Hear Sci 2013;3(3):45–51
 
KEYWORDS
ABSTRACT
Background:
The aim of this prospective study was to examine the link between Meniere’s disease and migrainous vertigo and assess the value of common non-invasive otoneurologic tests in the differential diagnosis.

Material and Methods:
A total of 38 patients with definite Meniere’s disease (MD), 24 with non Meniere’s vertigo, dizziness or unsteadiness (control group), and 10 patients with definite Vestibular Migraine (VM) underwent a full otoneurological screening which included an audiometric examination, extratympanic electrocochleography (ET – ECochG), cervical vestibular evoked myogenic potentials (cVEMPs) and videonystagmography with bithermal stimulation.

Results:
None VM patient presented with abnormal ECochG finding, in contrary to 61% of MD patients, and 4% in the control group. The difference was statistically significant (p<0.001). Pathological cVEMP results and unilateral weakness in caloric stimulation were found in 30% and 10% in VM population, whereas in 52.6% and 55.3% in MD. Again, the difference was statistically significant (p<0.001).

Conclusions:
The results indicate that certain vestibular test – as ECochG – could often help in the differentiation between VM and MD patients, especially in atypical cases. Last but not least, it seems that both diseases have a common electrophysiological background according to the similar cVEMP pathological findings.

 
REFERENCES (17)
1.
Neuhauser H, Lempert T. Vertigo and dizziness related to migraine: a diagnostic challenge. Cephalalgia, 2004; 24: 83–91.
 
2.
Baloh RW. Neurotology of migraine. Headache, 1997; 37: 615–21.
 
3.
Cutrer F, Baloh R. Migraine-associated dizziness. Headache, 1992; 32: 300–4.
 
4.
Katsarkas A. Hearing loss and vestibular dysfunction in Meniere’s disease. Acta Otolaryngol, 1996; 116: 185–88.
 
5.
Green JD Jr, Blum DJ, Harner SG. Longitudinal followup of patients with Meniere’s disease. Otolaryngol Head Neck Surg, 1991; 104: 783–88.
 
6.
Conlon BJ, Gibson WP. Electrocochleography in the diagnosis of Meniere’s disease. Acta Otolaryngol, 2000; 120: 480–83.
 
7.
Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S, Aydogan B. Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol, 1997; 106: 182–89.
 
8.
Lee H, Lopez I, Ishiyama A, Baloh RW. Can migraine damage the inner ear? Arch Neurol, 2000; 57: 1631–34.
 
9.
Ferraro J, Best LG, Arenberg IK. The use of electrocochleoraphy in the diagnosis, assessment, and monitoring of endolymphatic hydrops. Otolaryngol Clin North Am, 1983; 16: 69–82.
 
10.
Kim HH, Wiet RJ, Battista RA. Trends in the diagnosis and the management of Meniere’s disease: results of a survey. Otolaryngol Head Neck Surg, 2005; 132: 722–26.
 
11.
Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg, 1995; 113: 181–85.
 
12.
Baier B, Stieber N, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol, 2009; 256: 1447–54.
 
13.
Lempert T, Olesen J, Furman J et al. Vestibular migraine: diagnostic criteria. J Vestib Res, 2012; 22: 167–72.
 
14.
von Brevern M, Neuhauser H. Epidemiological evidence for a link between vertigo and migraine. J Vestib Res, 2011; 21: 299–304.
 
15.
Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H. Migraine and Meniere’s disease: is there a link? Neurology, 2002; 59: 1700–4.
 
16.
Rassekh CH, Harker LA. The prevalence of migraine in Meniere’s disease. Laryngoscope, 1992; 102: 135–38.
 
17.
von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T. Acute migrainous vertigo: clinical and oculographic findings. Brain, 2005; 128: 365–74.