Migraine/Meniere’s Overlap

 The two most common causes of recurrent episodes of prolonged vertigo (lasting at least 20-30 minutes) are Vestibular Migraine and Meniere’s disease.  Most practitioners make the distinction between the two by considering symptoms that accompany the vertigo attacks. Migrainuers often have visual complaints (increased sensitivity to light), and Meniere’s patient have unilateral auditory complaints (tinnitus, ear fullness, decreased and fluctuating hearing).

Researchers from California (UC Irvine) have posed a theory that Meniere’s may actually be a variant of migraine, suggesting that Meniere’s patients may benefit from migraine treatment instead of standard Meniere’s treatment. This is interesting to me because Meniere’s is poorly understood and not very responsive to treatment intended to regulate fluid pressure within the labyrinth. There are several theories regarding the cause of Meniere’s symptoms, but no one knows for sure.

They found a high overlap of migraine symptoms in patients that had previously been diagnosed with Meniere’s disease. They report that symptoms typically associated with migraine (such as increased “sensitivity to visual motion, light and sound, head motion, smells, weather changes or medication”) were present in 95% of patients that had previously been diagnosed with definite Meniere’s disease.

The theory proposed by Ghavami and colleagues involves repeated migraine type vasospasms in the small arteries feeding into the labyrinth and cochlea. They recommend treating Meniere’s patients with migraine medication, and report that this approach has been successful in their clinical trials.

This is attractive because treatments for migraine are not known for potentially toxic side effects, as are the most aggressive and effective treatments for Meniere’s disease.

 

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About Alan Desmond

Dr. Alan Desmond is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. In 2015, he received the Presidents Award from the American Academy of Audiology.

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Ina Rubloff

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John Ferraro

It is not unusual for individuals diagnosed with vestibular migraine to display electrocochleograms that are positive for endolymphatic hydrops. Thus, this condition would not be labeled as Meniere’s disease (MD) since the cause is known or at least strongly suspected. The relationship between vestibular migraine and MD needs to be studied further, but considering MAV treatment strategies among the options for individuals diagnosed with MD (and vice versa) certainly seems reasonable based on these new data.

Stacy

This makes a lot of sense to me. I have terrible sensitivity to light, sound and smells. And particular any light with a strobe effect like sunlight through trees or a bridge. I a curious is there a particular migraine treatment that has been effective for MAV sufferers?

Stacy

Also, I do have unilateral hearing loss so perhaps unfortunately both.