Comparison of audiometric, caloric, and cervical vestibular evoked myogenic potential test results between patients with Meniere's disease and vestibular migraine

梅尼爾氏病與前庭性偏頭痛病人之內耳功能檢查結果之比較

林秀茵(Hsiu-Yin Lin) ； 余瑞彬(Rui-Bin Yu) ； 陳一嘉(Yi-Jia Chen) ； 王守仁(Shou-Jen Wang) ； 劉必筠(Pi-Yun Liu) ； 施婉婷(Wan-Ting Shih) ； 陳正文(Jeng-Wen Chen)

《輔仁醫學期刊》 19卷2期 (2021/06) Pp. 1-9

https://doi.org/10.3966/181020932021061902001

摘要

Background and Purpose: Meniere's disease (MD) and vestibular migraine (VM) have overlapping clinical symptoms. We conducted a single-center observational study to examine the potential role of inner ear test batteries, namely the cervical vestibular-evoked myogenic potential (c-VEMP) and the caloric test, in the differentiation between patients with MD and VM. Methods: A retrospective chart review of patients presenting with dizziness or vertigo symptoms was performed from Feb 2018 to Feb 2019 in the outpatient clinic. All patients underwent complete history taking, physical examination, and an inner ear test battery. Eleven MD (9 females, aged 58.1 ± 11.7 years) and 19 VM patients (18 females, aged 42.3 ± 14.7 years) were enrolled for analysis. We examined the differences in clinical characteristics, presenting symptoms, and the presence of abnormal test results in audiometry, c-VEMP, and the caloric test between the two groups using a Fisher’s exact test. Results: Patients with VM were significantly younger than patients with MD (P = 0.001). Patients with MD had a significantly higher incidence of unilateral sensorineural hearing loss than patients with VM (P = 0.012). Caloric test results showed significantly higher abnormal response rates in the MD than in the VM group (72.7% vs. 26.3%, respectively, adjusted P = 0.030). In contrast, the c-VEMP test demonstrated no significant differences between the MD and VM groups in interaural difference abnormalities (0% vs. 10.5%, adjusted P = 0.544) and p13 delay or absent responses (36.4% vs. 10.5%, adjusted P = 0.298). Conclusion: The high rates of abnormal responses in caloric tests may facilitate distinguishing MD from VM.

關鍵字

Meniere's disease ； vestibular migraine ； inner ear test battery ； caloric test ； cervical vestibular-evoked myogenic potential (c-VEMP)

並列摘要

背景與目的：梅尼爾氏病和前庭性偏頭痛具有重疊的臨床症狀。本研究比較梅尼爾氏病和前庭性偏頭痛病人間，前庭誘發頸肌性電位及溫差眼振測驗的結果，探討內耳功能檢查是否有助於區分這兩種疾病。方法：共11位梅尼爾氏病病人及19位前庭性偏頭痛病人納入研究，我們使用費雪精確概率檢定比較兩組病人的差異。結果：前庭性偏頭痛較梅尼爾氏病病人年輕（P=0.001），但梅尼爾氏病病人較常見單側感覺神經性聽力損失（P=0.012），校正年齡後，溫差眼振測驗異常的比例在梅尼爾氏病高於前庭性偏頭痛病人（P=0.030）。結論：在梅尼爾氏病病人中，有較高比例出現溫差眼振測驗異常，可以輔助區別梅尼爾氏病與前庭性偏頭痛。

並列關鍵字

梅尼爾氏病 ； 前庭性偏頭痛 ； 內耳功能檢查 ； 溫差眼振測驗 ； 前庭誘發頸肌性電位