Affiliations: [a] Department of ORL, Haseki Training and Research Hospital, Istanbul, Turkey | [b] Department of Neurology, Haseki Training and Research Hospital, Istanbul, Turkey | [c] Department of ORL, Derince Training and Research Hospital, Kocaeli, Turkey
Abstract: Overlaps can be seen between vestibular migraine (VM) Ménière's
Disease (MD) and diagnosis is difficult if hearing is normal. We aimed to
investigate the sacculo-collic pathway in VM patients, MD patients, and
healthy controls to define the diagnostic role of cervical VEMP (cVEMP).
VEMP testing in response to 500 Hz and 1000 Hz air-conducted tone burst (TB)
stimulation was studied prospectively in 22 subjects with definite VM
(according to Bárány nomenclature), 30 subjects with unilateral
definite MD, and 18 volunteers matched healthy controls. In VM subjects, response
rate, p13 and n23 latencies were similar to healthy controls, but
peak-to-peak amplitudes were bilaterally reduced at 500 Hz TBs (p= 0.005).
cVEMP differentiated MD patients from VM and healthy controls with
asymmetrically reduced amplitudes on affected ears with low response rates
at 500 Hz TBs, and alteration of frequency dependent responses at 500 and
1000 Hz TBs. These findings suggest that cVEMP can be used as a diagnostic
test to differentiate MD from VM. On the other hand, VEMP responses are
symmetrically reduced on both sides in VM patients, suggesting that otolith
organs might be affected by migraine-induced ischemia.
