title: Accompanying Symptoms Overlap during Attacks in Menière's Disease and Vestibular Migraine.
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.
authors.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.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Lopez-Escamez
authors.affiliation: Department of Otorhinolaryngology, Saarland University Medical Center , Homburg , Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Dlugaiczyk
authors.affiliation: Public Research Centre for Health (CRP-Santé), Center for Health Studies , Luxembourg , Luxembourg.
authors.forename: Julien
authors.initials: J
authors.lastname: Jacobs
authors.affiliation: Department of Neurology, Schlosspark-klinik , Berlin , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lempert
authors.affiliation: ENT Division, San Raffaele Scientific Institute , Milan , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Teggi
authors.affiliation: Department of Neurology, Park-Klinik Weissensee , Berlin , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: von Brevern
authors.affiliation: Department of Neurology, Centre Hospitalier Emile Mayrisch , Esch-sur-Alzette , Luxembourg.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bisdorff
keywords: clinical diagnosis; headache; migraine; sensorineural hearing loss; vertigo; vestibular disorders