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.