Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography
Objectives: The diagnostic criteria for vestibular migraine (VM) and Méniere’s disease (MD) present an important overlap, which leads to a difficult diagnosis in patients presenting with headache, vertigo, hearing loss, ear fullness, and tinnitus. The objective of our study is to determine whether t...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Audiology Research |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2039-4349/13/1/2 |
| _version_ | 1797622391786962944 |
|---|---|
| author | Paul Tabet Ahlem Elblidi Issam Saliba |
| author_facet | Paul Tabet Ahlem Elblidi Issam Saliba |
| author_sort | Paul Tabet |
| collection | DOAJ |
| description | Objectives: The diagnostic criteria for vestibular migraine (VM) and Méniere’s disease (MD) present an important overlap, which leads to a difficult diagnosis in patients presenting with headache, vertigo, hearing loss, ear fullness, and tinnitus. The objective of our study is to determine whether the area-under-the-curve ratio of the summating potentials (SP) and action potentials (AP) curves on electrocochleography (ECoG) helps differentiate VM from MD with or without the use of the well-established clinical criteria. Method: A retrospective review of patients filling either VM or MD criteria was undertaken between September 2015 and December 2018. All patients underwent ECoG before the introduction of anti-migraine therapy. The prediction of symptom improvement between the clinical criteria and ECoG results was compared by using the Vertigo Symptom Scale. Results: In total, 119 patients were included. An overlap of 36% exists between patients filling VM and MD criteria. Clinical criteria alone did not demonstrate a significant prediction of symptom response to anti-migraine therapy (VM 83%, MD 51%; <i>p</i> = 0.10). However, ECoG results alone did demonstrate adequate prediction (VM 94%, MD 32%; <i>p</i> < 0.001). A negative ECoG result combined with the clinical criteria of VM (100% symptom improvement) was shown to be more predictive of treatment response when compared to clinical criteria alone (83% symptom improvement) (<i>p</i> = 0.017). Finally, when used in patients filling both the VM and MD criteria (VMMD), ECoG was able to predict symptom improvement, thus better differentiating both diseases (normal ECoG: 95%, abnormal ECoG 29%; <i>p</i> < 0.001). Conclusion: Combining VM criteria with normal ECoG using the AUC ratio seems superior in predicting adequate symptom improvement than VM criteria alone. |
| first_indexed | 2024-03-11T09:09:37Z |
| format | Article |
| id | doaj.art-0e792cb864e24b998cebbeb5b11d433b |
| institution | Directory Open Access Journal |
| issn | 2039-4349 |
| language | English |
| last_indexed | 2024-03-11T09:09:37Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Audiology Research |
| spelling | doaj.art-0e792cb864e24b998cebbeb5b11d433b2023-11-16T19:04:59ZengMDPI AGAudiology Research2039-43492022-12-01131122210.3390/audiolres13010002Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of ElectrocochleographyPaul Tabet0Ahlem Elblidi1Issam Saliba2Division of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, CanadaDivision of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, CanadaDivision of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, CanadaObjectives: The diagnostic criteria for vestibular migraine (VM) and Méniere’s disease (MD) present an important overlap, which leads to a difficult diagnosis in patients presenting with headache, vertigo, hearing loss, ear fullness, and tinnitus. The objective of our study is to determine whether the area-under-the-curve ratio of the summating potentials (SP) and action potentials (AP) curves on electrocochleography (ECoG) helps differentiate VM from MD with or without the use of the well-established clinical criteria. Method: A retrospective review of patients filling either VM or MD criteria was undertaken between September 2015 and December 2018. All patients underwent ECoG before the introduction of anti-migraine therapy. The prediction of symptom improvement between the clinical criteria and ECoG results was compared by using the Vertigo Symptom Scale. Results: In total, 119 patients were included. An overlap of 36% exists between patients filling VM and MD criteria. Clinical criteria alone did not demonstrate a significant prediction of symptom response to anti-migraine therapy (VM 83%, MD 51%; <i>p</i> = 0.10). However, ECoG results alone did demonstrate adequate prediction (VM 94%, MD 32%; <i>p</i> < 0.001). A negative ECoG result combined with the clinical criteria of VM (100% symptom improvement) was shown to be more predictive of treatment response when compared to clinical criteria alone (83% symptom improvement) (<i>p</i> = 0.017). Finally, when used in patients filling both the VM and MD criteria (VMMD), ECoG was able to predict symptom improvement, thus better differentiating both diseases (normal ECoG: 95%, abnormal ECoG 29%; <i>p</i> < 0.001). Conclusion: Combining VM criteria with normal ECoG using the AUC ratio seems superior in predicting adequate symptom improvement than VM criteria alone.https://www.mdpi.com/2039-4349/13/1/2electrocochleographyECoGECochGvestibular migraineMéniere’s diseasemigraine |
| spellingShingle | Paul Tabet Ahlem Elblidi Issam Saliba Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography Audiology Research electrocochleography ECoG ECochG vestibular migraine Méniere’s disease migraine |
| title | Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography |
| title_full | Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography |
| title_fullStr | Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography |
| title_full_unstemmed | Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography |
| title_short | Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography |
| title_sort | vestibular migraine versus meniere s disease diagnostic utility of electrocochleography |
| topic | electrocochleography ECoG ECochG vestibular migraine Méniere’s disease migraine |
| url | https://www.mdpi.com/2039-4349/13/1/2 |
| work_keys_str_mv | AT paultabet vestibularmigraineversusmenieresdiseasediagnosticutilityofelectrocochleography AT ahlemelblidi vestibularmigraineversusmenieresdiseasediagnosticutilityofelectrocochleography AT issamsaliba vestibularmigraineversusmenieresdiseasediagnosticutilityofelectrocochleography |