What is the Difference Between Meniere’s Disease and Vestibular Migraine?

Meniere's Disease (MD) and Vestibular Migraine (VM) are both episodic vestibular syndromes with overlapping symptoms, making their differentiation challenging. However, there are some differences between the two conditions:

1. Vertigo duration: MD patients may experience vertigo attacks lasting for hours, while VM patients can experience vertigo lasting from seconds to days.
2. Associated symptoms: VM patients typically experience more headaches, photophobia, vomiting, and aura during their episodes.
3. Hearing loss: MD is characterized by fluctuating hearing loss, tinnitus, or ear fullness. VM does not have the same hearing loss characteristics as MD.
4. Diagnostic criteria: The International Headache Society and Barany Society have established diagnostic criteria for VM and MD, respectively. These criteria are primarily based on clinical findings, and no known definitive diagnostic tests can reliably distinguish between the two conditions.

The differentiation between MD and VM is crucial, as their treatments are different. Since the two illnesses can overlap in all aspects, no single test is sufficiently specific on its own. However, patterns containing all or at least some features can boost specificity. It is important for patients experiencing symptoms of vertigo or dizziness to consult a vestibular specialist for appropriate testing and diagnosis.

Comparative Table: Meniere’s Disease vs Vestibular Migraine

Here is a table comparing Meniere's Disease and Vestibular Migraine:

Despite the similarities in symptoms, there are some differences between Meniere's Disease and Vestibular Migraine. Meniere's Disease typically affects older individuals and has a higher prevalence in males, while Vestibular Migraine affects younger individuals and has a higher prevalence in females. The diagnostic criteria for both conditions are also different, with Meniere's Disease requiring episodes of vertigo, low tone hearing loss, aural fullness or tinnitus, and fluctuating hearing loss, while Vestibular Migraine requires episodes of vestibular symptoms with a duration of at least 5 minutes and a migraine history or association with migraine features.