Evaluation of VEMP findings in migrainous vertigo, migraine and Meniere's disease

Utkur B. Ç., Durankaya S. M., Idiman F., ŞERBETÇİOĞLU M. B., Guneri A.

Journal of International Advanced Otology, vol.9, no.3, pp.359-367, 2013 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 9 Issue: 3
  • Publication Date: 2013
  • Journal Name: Journal of International Advanced Otology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.359-367
  • Istanbul Medipol University Affiliated: No


Objective: Studying the physiopathologic relationship between Meniere's disease and migrainous vertigo, subclinic vestibular exposure in the asymptomatic ear of the Meniere's disease patients and in migraine patients, and the relationship between the hearing of Meniere's disease and vestibular function by applying vestibular evoked myogenic potentials [VEMP] test to migraine, migrainous vertigo and Meniere's disease patients who suffer from headache and/or vertigo. Study Design: Prospective study. Setting: University hospital. Patients: 26 migrainous vertigo, 26 Meniere disease, 22 migrain patients and 27 healthy cases that didn't suffer from headache and vertigo Intervention(s): Monaural 500 Hz tone-burst stimulant VEMP test was applied on cases. Visual headache stimulation also was applied on migraine cases and the obtained VEMP responses were recorded separately. Main Outcome Measure(s): VEMP response parameters (treshold, latency, interpeak amplitude, amplitude assimetry ratio). Results: While a VEMP response was obtained from all the cases in the control group, no response could be obtained from 9 ears in migraine group (20,4 %), 5 ears from migrainous vertigo group (9,6 %), 11 ears which were diagnosed with Meniere's disease (35,5%) and 3 ears in Meniere's disease group which weren't diagnosed with Meniere's disease. When compared to the control group; threshold stimulant intensity was higher in Meniere's disease group, the threshold stimulus intensity was higher, interpeak amplitude value decreased and amplitude asymmetry ratio increased in migrainous vertigo group, the interpeak amplitude value and latency periods were shorter in migraine group. When Meniere's disease is compared to migrainous vertigo group, significant differences were not identified in all parameters. No statistically significant difference was observed between pre and post-headache stimulation VEMP records of migraine cases. No statistically significant difference was detected among healthy and unhealthy ears of Meniere's disease patients and between subgroups of early and late Meniere's disease. Conclusion: The findings obtained in migrainous vertigo group were considered in favour of peripheral vestibular exposure. The physiopathologic link between migrainous vertigo and Meniere's disease groups was obtained. While subclinical vestibular exposure was identified in the migraine group, lack of change in post-headache stimulation findings gave rise to the thought that the subclinical exposure identified prior to stimulation does not increase with attack. Nonetheless, it was also thought the reason might be that the migraine stimulation mechanism applied is not effective enough to activate the vestibular system. The fact that no difference was identified in comparison of parameters in healthy and unhealthy ears of Meniere's disease was received as finding of asymptomatic saccular exposure in healthy ears of Meniere's disease patients. No relation was detected between hearing thresholds of Meniere's disease patients and VEMP responses and it was shown that hearing function progresses independently from vestibular function. Prognosis of asymptomatic ear and vestibular function can be followed up through VEMP test in patients of Meniere's disease. Copyright 2005 © The Mediterranean Society of Otology and Audiology.