Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine

Brian A. Neff, Jeffrey P Staab, Scott Daniel Eggers, Matthew L. Carlson, William R. Schmitt, Kathryn M. Van Abel, Douglas K. Worthington, Charles W. Beatty, Colin L. Driscoll, Neil T. Shepard

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

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). STUDY DESIGN: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD. SETTING: Ambulatory, tertiary dizziness clinic. PATIENTS: Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD. INTERVENTIONS: Diagnostic consultation. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)1235-1244
Number of pages10
JournalOtology and Neurotology
Volume33
Issue number7
DOIs
StatePublished - Sep 2012

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Vestibular Diseases
Dizziness
Migraine Disorders
Ear
Headache

Keywords

  • Chronic subjective dizziness
  • Dizziness
  • ertigo
  • estibular migraine
  • Ménière'sdisease
  • Migraine
  • Sensorineural hearing loss

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine. / Neff, Brian A.; Staab, Jeffrey P; Eggers, Scott Daniel; Carlson, Matthew L.; Schmitt, William R.; Van Abel, Kathryn M.; Worthington, Douglas K.; Beatty, Charles W.; Driscoll, Colin L.; Shepard, Neil T.

In: Otology and Neurotology, Vol. 33, No. 7, 09.2012, p. 1235-1244.

Research output: Contribution to journalArticle

Neff, Brian A. ; Staab, Jeffrey P ; Eggers, Scott Daniel ; Carlson, Matthew L. ; Schmitt, William R. ; Van Abel, Kathryn M. ; Worthington, Douglas K. ; Beatty, Charles W. ; Driscoll, Colin L. ; Shepard, Neil T. / Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine. In: Otology and Neurotology. 2012 ; Vol. 33, No. 7. pp. 1235-1244.
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abstract = "OBJECTIVE: To compare presentations of M{\'e}ni{\`e}re's disease (MD), vestibular migraine (VM), and M{\'e}ni{\`e}re's disease plus vestibular migraine (MDVM), with and without comorbid chronic subjective dizziness (CSD). STUDY DESIGN: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD. SETTING: Ambulatory, tertiary dizziness clinic. PATIENTS: Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD. INTERVENTIONS: Diagnostic consultation. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.",
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AU - Neff, Brian A.

AU - Staab, Jeffrey P

AU - Eggers, Scott Daniel

AU - Carlson, Matthew L.

AU - Schmitt, William R.

AU - Van Abel, Kathryn M.

AU - Worthington, Douglas K.

AU - Beatty, Charles W.

AU - Driscoll, Colin L.

AU - Shepard, Neil T.

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N2 - 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). STUDY DESIGN: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD. SETTING: Ambulatory, tertiary dizziness clinic. PATIENTS: Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD. INTERVENTIONS: Diagnostic consultation. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.

AB - 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). STUDY DESIGN: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD. SETTING: Ambulatory, tertiary dizziness clinic. PATIENTS: Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD. INTERVENTIONS: Diagnostic consultation. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.

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KW - Dizziness

KW - ertigo

KW - estibular migraine

KW - Ménière'sdisease

KW - Migraine

KW - Sensorineural hearing loss

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