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Auditory and Vestibular Symptoms and Chronic Subjective Dizziness in Patients With Ménière's Disease, Vestibular Migraine, and Ménière's Disease With Concomitant Vestibular Migraine.
MedLine Citation:
PMID:  22801040     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Brian A Neff; Jeffrey P Staab; Scott D Eggers; Matthew L Carlson; William R Schmitt; Kathryn M Van Abel; Douglas K Worthington; Charles W Beatty; Colin L Driscoll; Neil T Shepard
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-13
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  -     ISSN:  1537-4505     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of *Otolaryngology-Head and Neck Surgery, †Department of Psychiatry and Behavioral Medicine, and ‡Department of Neurology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
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