Differences of the findings of MRI between Meniere's disease and vestibular migrane

Abstract

　Vestibular migraine is a disease characterized by vertigo attacks associated with migraine symptoms such as headache, photosensitivity, and hyperacusis; it has come to be recognized as an important disease in recent years. On the other hand, Meniere's disease is a disease characterized by recurrent vertigo, the dizziness accompanied by cochlear symptoms such as hearing loss or tinnitus. It is often difficult to distinguish between the two conditions, and moreover, some patients suffer from both diseases. Recently, magnetic resonance imaging with intravenous gadolinium injection has been shown to be useful to detect endolymphatic hydrops, the salient pathological feature of Meniere's disease. In the present study, we performed magnetic resonance imaging in patients with Meniere's disease and vestibular migraine, including a total of 128 patients with a definitive diagnosis of Meniere's disease, 9 patients with vestibular-type Meniere's disease, and 19 patients with vestibular migraine. Among the affected ears of patients with a definitive diagnosis of Meniere's disease, 78.1% showed endolymphatic hydrops, while only 5.6% of the ears of patients with the vestibular migraine revealed endolymphatic hydrops. The incidence of endolymphatic hydrops among patients with a definitive diagnosis of Meniere's disease was significantly higher than that in the patients with vestibular migraine (p<0.05, chi-square test). This difference could be helpful in the differential diagnoses of Meniere's disease from vestibular migraine, and therefore, in the selection of the appropriate treatment for patients with the two diseases.