Vertigo and headache are both common symptoms and could coexist. Vestibular migraine (VM) is characterized by recurrent attacks of vertigo with concomitant headache fulfilling the diagnostic criteria for migraine. It is important to distinguish VM from Meniere's disease (MD), because the symptoms are similar, but MD often also coexists with VM. The term “VM/MD overlap syndrome” has been suggested for cases in which different types of vertigo attributable to VM and MD coexist. Delayed endolymphatic hydrops (DEH) is a clinical entity characterized by recurrent vertigo developing years to decades after the onset of severe sensorineural hearing loss; the pathology is similar to that of MD. We encountered a case suspected overlap of VM and DEH.
A 65-year-old male patient with a history of onset of sudden hearing loss in the right ear 15 years earlier visited us with complaints of recurrent vertigo and headache. He was diagnosed as having VM; his “dizziness and headache diary” revealed simultaneous onset of migraine-like headache and vertigo. He was also diagnosed as having ipsilateral DEH, because both the vertigo and headache resolved with isosorbide; lomerizine hydrochloride, used previously, improved, but did not resolve the symptoms.
We diagnosed this patient as a case of suspected overlap of VM and DEH, based on the coexistence of the signs and symptoms of VM and DEH. This is the first report of a case of overlap of VM and DEH; a relationship appears to exist between VM and not only MD, but also DEH.
