Can VEMPs Help Differentiate Ménière Disease from Vestibular Migraine?

Abstract

Objective: To determine if results from cervical vestibular evoked myogenic potential and ocular (oVEMP) testing can help differentiate Ménière’s disease (MD) from vestibular migraine (VM).

Method: Subjects: Age-matched controls (n = 16), unilateral definite MD patients (n = 23), VM patients (n = 9) by Neuhauser’s criteria. Intervention(s): Click and 500-Hz tone-evoked c- and oVEMPs. VM patients were further classified based on localization of symptoms. Outcome measure(s): CVEMP: corrected peak-to-peak amplitudes; oVEMP: n10 amplitudes.

Results: Five VM patients were able to localize their symptoms to one ear. Relative to controls, MD and VM groups both showed reduced click-evoked cVEMP (P < .002) and oVEMP (P < .026) amplitudes. Only the MD group showed reduction in tone-evoked amplitudes for cVEMP (P = .011). Tone-evoked oVEMPs differentiated MD from VM patients (P = .027), but only for VM patients who did not localize their symptoms to one ear (P = .013).

Conclusion: C- and oVEMP amplitudes are reduced in response to clicks in VM. 500-Hz tone-evoked oVEMPs may differentiate VM patients without localizing ear symptoms from MD, but those with localizing symptoms may have a similar pathophysiology to MD.