生理機能検査の視点から

抄録

　Meniere's disease refers to a peripheral vestibular disorder characterized by recurrent vertigo and cochlear symptoms, and the underlying pathophysiology is thought to be endolymphatic hydrops. Vestibular migraine is a relatively new disease concept that manifests as recurrent vertigo, whose pathophysiology still remains unclear. Comparison of the physiological characteristics of these two diseases might help in elucidating the pathophysiology of vestibular migraine, and in this paper, the similarities and differences between the two diseases are described from the viewpoint of the findings of physiological examination.

　Meniere's disease is characterized by unilateral vestibular dysfunction, which is not disease-specific. Positive results of tests for endolymphatic hydrops, such as the furosemide test and furosemide-loading VEMP are specific for the disease. Patients who showed unilateral canal paresis on caloric testing did not show lower VOR gain in the video head impulse test (vHIT), which is also specific for the disease.

　About 18%-42% of patients with vestibular migraine show unilateral dysfunction on caloric testing. Many patients with unilateral canal paresis on caloric testing did not show a low VOR gain on vHIT, similar to the case of Meniere's disease. The peak-to-peak amplitude of cVEMP and oVEMP may show a decrease. Some tests for endolymphatic hydrops show positive results.

　The findings could be summarized as follows; vestibular dysfunction is not uncommon in vestibular migraine. The tests show that endolymphatic hydrops could be associated with vestibular migraine, however, it is not clear if this is the cause or the result of the disease.