Comparison of clinical characteristics and vestibular function test results in patients with vestibular migraine and Meniere's disease

Objectives: The differentiation between Vestibular Migraine (VM) and Meniere's Disease (MD) is difficult because of overlapping symptoms. The study aimed to compare the clinical charac-teristics and vestibular function test results between VM and MD patients. Methods: Seventy-one patients with definite VM and 31 patients with definite unilateral MD were included. All patients received Caloric Test (CT), Video Head Impulse Test (vHIT) and Vestibular Evoked Myogenic Potential (VEMP) test within 7 days after visiting the hospital. Results of these tests were compared between groups. Results: Most VM patients (64.0%) experienced spontaneous internal vertigo, while most MD patients (66.7%) experienced spontaneous external vertigo. MD patients had more severe vestibular symptoms and autonomic responses compared to VM patients during attacks (p = 0.03, p = 0.00, respectively). The nystagmus intensity of CT-induced was greater in VM patients than in MD patients (p = 0.003). More VM patients had CT intolerance and Central Posi-tional Nystagmus (CPN) compared to MD patients (p = 0.002, p = 0.006, respectively). More MD patients had CT(+) and vHIT saccades wave compared to VM patients (p < 0.001, p = 0.002, respectively). The non-elicitation rate of cervical VEMP was higher, and the ocular VEMP ampli-tudes were lower in MD patients than in VM patients (p = 0.002, p = 0.018). Conclusions: Vestibular symptoms during attacks combined with the results of vestibular func-tion tests may be used to differentiate between VM and MD. The diverse nature of vestibular symptoms (especially internal vertigo), history of motion sickness and CT intolerance may pro-vide clues to the diagnosis of VM, whereas spontaneous external vertigo, CT(+) with vHIT(-), and the presence of saccades may provide clues to the diagnosis of MD. Level of evidence: 4. & COPY; 2023 Published by Elsevier Espan & SIM;a, S.L.U. on behalf of Associacao Brasileira de Otorrino-laringologia e Cirurgia C & PRIME;ervico-Facial. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).