Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine.
OBJECTIVE
To compare presentations of Ménière's disease (MD), vestibular migraine (VM), and Ménière's disease plus vestibular migraine (MDVM), with and without comorbid chronic subjective dizziness (CSD).


METHODS
Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD.


METHODS
Ambulatory, tertiary dizziness clinic.


METHODS
Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD.


METHODS
Diagnostic consultation.


METHODS
Similarities and differences between diagnostic groups in demographics; symptoms; and results of neurotologic, audiometric, and vestibular laboratory assessments.


RESULTS
Seventy-six patients had MD, 55 MD alone. Ninety-two patients had VM, 71 VM alone. Twenty-one patients had MDVM, representing about one-quarter of those diagnosed with MD or VM. Clinical features thought to differentiate VM from MD were found in all groups. Twenty-seven patients with VM (38%) had ear complaints (subjective hearing loss, aural pressure, and tinnitus) during episodes of vestibular symptoms and headache, including 10 (37%) with unilateral symptoms. Conversely, 27 patients with MD alone (49%) had headaches with migraine features that did not meet full IHS diagnostic criteria, migrainous symptoms (photophobia, headache with vomiting), or first-degree relative with migraine. Including MDVM patients, 59% (45/76) of all patients with MD had migrainous features. Thirty-two patients had CSD; most (29; 91%) were in the VM group.


CONCLUSIONS
Comorbidity was common between MD and VM, and their symptoms overlapped. More specific diagnostic criteria are needed to differentiate these diseases and address their coexistence. CSD co-occurred with VM but was rarely seen with MD.
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota 55905, USA. neff.brian@mayo.edu
Brian A
BA
Neff
Jeffrey P
JP
Staab
Scott D
SD
Eggers
Matthew L
ML
Carlson
William R
WR
Schmitt
Kathryn M
KM
Van Abel
Douglas K
DK
Worthington
Charles W
CW
Beatty
Colin L
CL
Driscoll
Neil T
NT
Shepard
D000328:Adult; D004244:Dizziness / Q000150:complications / Q000175:diagnosis*; D005260:Female; D034381:Hearing Loss / Q000150:complications; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000175:diagnosis*; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis*; D020795:Photophobia / Q000150:complications; D012189:Retrospective Studies; D014012:Tinnitus / Q000150:complications