Limits...
Accompanying Symptoms Overlap during Attacks in Menière's Disease and Vestibular Migraine.

Lopez-Escamez JA, Dlugaiczyk J, Jacobs J, Lempert T, Teggi R, von Brevern M, Bisdorff A - Front Neurol (2014)

Bottom Line: The female/male ratio was statistically higher in VM/pVM as compared to MD, while the age of onset was significantly lower in the former two.In conclusion, the present study confirms a considerable overlap of symptoms in MD, VM, and pVM.In particular, we could not identify any highly specific symptom for one of the three entities.

View Article: PubMed Central - PubMed

Affiliation: Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research, Pfizer/Universidad de Granada/Junta de Andalucía (GENyO) , Granada , Spain ; Department of Otolaryngology, Hospital de Poniente, El Ejido , Almeria , Spain.

ABSTRACT
Menière's disease and vestibular migraine (VM) are the most common causes of spontaneous recurrent vertigo. The current diagnostic criteria for the two disorders are mainly based on patients' symptoms, and no biological marker is available. When applying these criteria, an overlap of the two disorders is occasionally observed in clinical practice. Therefore, the present prospective multicenter study aimed to identify accompanying symptoms that may help to differentiate between MD, VM, and probable vestibular migraine (pVM). Two hundred and sixty-eight patients were included in the study (MD: n = 119, VM: n = 84, pVM: n = 65). Patients with MD suffered mainly from accompanying auditory symptoms (tinnitus, fullness of ear, and hearing loss), while accompanying migraine symptoms (migraine-type headache, photo-/phonophobia, visual aura), anxiety, and palpitations were more common during attacks of VM. However, it has to be noted that a subset of MD patients also experienced (migraine-type) headache during the attacks. On the other hand, some VM/pVM patients reported accompanying auditory symptoms. The female/male ratio was statistically higher in VM/pVM as compared to MD, while the age of onset was significantly lower in the former two. The frequency of migraine-type headache was significantly higher in VM as compared to both pVM and MD. Accompanying headache of any type was observed in declining order in VM, pVM, and MD. In conclusion, the present study confirms a considerable overlap of symptoms in MD, VM, and pVM. In particular, we could not identify any highly specific symptom for one of the three entities. It is rather the combination of symptoms that should guide diagnostic reasoning. The identification of common symptom patterns in VM and MD may help to refine future diagnostic criteria for the two disorders.

No MeSH data available.


Related in: MedlinePlus

Relative frequency of headache and migraine-type headache during the episode of vestibular symptoms among patients with Menière’s disease (MD), vestibular migraine (VM), and probable VM (pVM).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4265699&req=5

Figure 1: Relative frequency of headache and migraine-type headache during the episode of vestibular symptoms among patients with Menière’s disease (MD), vestibular migraine (VM), and probable VM (pVM).

Mentions: One hundred and nineteen patients with MD were included in the study. The age at onset of vertigo was 48 ± 13 years and the female/male ratio was 1.2. The accompanying symptoms reported during the episodes of vertigo are shown in Table 2. The most common symptoms in patients with MD (total frequency) were nausea (94%), vomiting (84%), and tinnitus (83%). Accompanying hearing loss was reported in 77% of cases, headache was found in 41% of patients with MD, and migraine-type headache was observed in 8.4% of MD patients during the attack (Figure 1). Although we did not study the relationship between perceived hearing loss and hearing threshold in the audiogram systematically, we noted that some patients with MD, who did not report hearing loss during attacks, had a profound chronic sensorineural hearing loss on the audiogram (>70 dB normal hearing level).


Accompanying Symptoms Overlap during Attacks in Menière's Disease and Vestibular Migraine.

Lopez-Escamez JA, Dlugaiczyk J, Jacobs J, Lempert T, Teggi R, von Brevern M, Bisdorff A - Front Neurol (2014)

Relative frequency of headache and migraine-type headache during the episode of vestibular symptoms among patients with Menière’s disease (MD), vestibular migraine (VM), and probable VM (pVM).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265699&req=5

Figure 1: Relative frequency of headache and migraine-type headache during the episode of vestibular symptoms among patients with Menière’s disease (MD), vestibular migraine (VM), and probable VM (pVM).
Mentions: One hundred and nineteen patients with MD were included in the study. The age at onset of vertigo was 48 ± 13 years and the female/male ratio was 1.2. The accompanying symptoms reported during the episodes of vertigo are shown in Table 2. The most common symptoms in patients with MD (total frequency) were nausea (94%), vomiting (84%), and tinnitus (83%). Accompanying hearing loss was reported in 77% of cases, headache was found in 41% of patients with MD, and migraine-type headache was observed in 8.4% of MD patients during the attack (Figure 1). Although we did not study the relationship between perceived hearing loss and hearing threshold in the audiogram systematically, we noted that some patients with MD, who did not report hearing loss during attacks, had a profound chronic sensorineural hearing loss on the audiogram (>70 dB normal hearing level).

Bottom Line: The female/male ratio was statistically higher in VM/pVM as compared to MD, while the age of onset was significantly lower in the former two.In conclusion, the present study confirms a considerable overlap of symptoms in MD, VM, and pVM.In particular, we could not identify any highly specific symptom for one of the three entities.

View Article: PubMed Central - PubMed

Affiliation: Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research, Pfizer/Universidad de Granada/Junta de Andalucía (GENyO) , Granada , Spain ; Department of Otolaryngology, Hospital de Poniente, El Ejido , Almeria , Spain.

ABSTRACT
Menière's disease and vestibular migraine (VM) are the most common causes of spontaneous recurrent vertigo. The current diagnostic criteria for the two disorders are mainly based on patients' symptoms, and no biological marker is available. When applying these criteria, an overlap of the two disorders is occasionally observed in clinical practice. Therefore, the present prospective multicenter study aimed to identify accompanying symptoms that may help to differentiate between MD, VM, and probable vestibular migraine (pVM). Two hundred and sixty-eight patients were included in the study (MD: n = 119, VM: n = 84, pVM: n = 65). Patients with MD suffered mainly from accompanying auditory symptoms (tinnitus, fullness of ear, and hearing loss), while accompanying migraine symptoms (migraine-type headache, photo-/phonophobia, visual aura), anxiety, and palpitations were more common during attacks of VM. However, it has to be noted that a subset of MD patients also experienced (migraine-type) headache during the attacks. On the other hand, some VM/pVM patients reported accompanying auditory symptoms. The female/male ratio was statistically higher in VM/pVM as compared to MD, while the age of onset was significantly lower in the former two. The frequency of migraine-type headache was significantly higher in VM as compared to both pVM and MD. Accompanying headache of any type was observed in declining order in VM, pVM, and MD. In conclusion, the present study confirms a considerable overlap of symptoms in MD, VM, and pVM. In particular, we could not identify any highly specific symptom for one of the three entities. It is rather the combination of symptoms that should guide diagnostic reasoning. The identification of common symptom patterns in VM and MD may help to refine future diagnostic criteria for the two disorders.

No MeSH data available.


Related in: MedlinePlus