A case of Ménière's disease needed to be differentiated from a vestibular migraine

Abstract

A–37–year–old man with a history of migraine without aura developed his ear fullness (day 1). On day 3, he developed dizziness, headache which worsened when he stood up, and vomiting. Rizatriptan was ineffective. Brain magnetic resonance imaging showed no abnormality and he visited otorhinolaryngology. He had no nystagmus. An audiogram revealed his left low–tone hearing loss. Ménière's disease was suspected, and isosorbide was started. Headache with dizziness diminished gradually. On day 13, the audiogram showed no abnormality, and other symptoms disappeared on day 20. Hearing loss without headache recurred after 7 months. The symptom was relieved by adenosine triphosphate disodium hydrate. Afterward, he had no relapse. Differential diagnosis initially included vestibular migraine. Eventually, the headache persisted for more than 72 hours, and a vestibular migraine was excluded. Headache was considered to be due to Ménière's disease. Migraine is often associated with Ménière's disease. If a patient with migraine shows a headache with dizziness, not only a vestibular migraine but also Ménière's disease should be considered.