1. Accompanying Symptoms Overlap during Attacks in Menière’s Disease and Vestibular Migraine
- Author
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Alexandre Bisdorff, Thomas Lempert, Julien Jacobs, Michael von Brevern, Julia Dlugaiczyk, Roberto Teggi, Jose A. Lopez-Escamez, [Lopez-Escamez,JA] Ototogy and Neurology Group, Department of Genomic Medicine, Centre for Genomics and Oncology Research, Pfizer/Universidad de Granada/Junta de Andalucía (GENyO), Granada, Spain. [Lopez-Escamez,JA] Department of Otolaryngology, Hospital de Poniente, El Ejido, Almeria, Spain. [Dlugaiczyk,J] Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Germany. [Jacobs,J] Public Research Centre for Health (CRP-Santé), Center for Health Studies, Luxembourg, Luxembourg. [Lempert,T] Department of Neurology, Schlosspark-klinik, Berlin, Germany. [Teggi,R] ENT Division, San Raffaele Scientific Institute, Milan, Italy. [Von Brevern,M] Department of Neurology, Park-klinik Weissensee, Berlin, Germany. [Bisdorff,A] Department of Neurology, Centre Hospitalier Emile Mayrich, Esch-sur-Alzette, Luxembourg., and This study was supported by a grant from CRP Santé and the Ministère de l’Enseignement Supérieur et de la Recherche, Grand-Duché de Luxembourg.
- Subjects
Diagnóstico clínico ,Pediatrics ,Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Epilepsy [Medical Subject Headings] ,Psychiatry and Psychology::Mental Disorders::Anxiety Disorders [Medical Subject Headings] ,sensorineural hearing loss ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,vestibular disorders ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hearing Loss::Deafness [Medical Subject Headings] ,Vertigo ,Palpitations ,migraine ,Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine Disorders [Medical Subject Headings] ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Labyrinth Diseases::Endolymphatic Hydrops::Meniere Disease [Medical Subject Headings] ,Original Research ,biology ,Headache ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hearing Loss::Hearing Loss, Sensorineural [Medical Subject Headings] ,Clinical diagnosis ,Sensorineural hearing loss ,Phonophobia ,clinical diagnosis ,Neurology ,medicine.symptom ,Enfermedades vestibulares ,Chemicals and Drugs::Biological Factors::Biological Markers::Biomarkers, Pharmacological [Medical Subject Headings] ,headache ,medicine.medical_specialty ,Pérdida auditiva sensorineural ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Labyrinth Diseases::Vestibular Diseases::Vertigo [Medical Subject Headings] ,Vestibular disorders ,vertigo ,Migraña con aura ,medicine ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Tinnitus [Medical Subject Headings] ,Psychiatry ,Migraine ,business.industry ,Enfermedad de Meniere ,biology.organism_classification ,medicine.disease ,Diseases::Nervous System Diseases::Neurologic Manifestations::Pain::Headache [Medical Subject Headings] ,Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hyperacusis [Medical Subject Headings] ,Cefalea ,Neurology (clinical) ,Age of onset ,business ,Tinnitus ,Meniere's disease ,Neuroscience - Abstract
Meniere’s disease and vestibular migraine 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 multi-center study aimed to identify accompanying symptoms that may help to differentiate between Meniere’s disease (MD), vestibular migraine (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.
- Published
- 2014
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