{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:08:51Z","timestamp":1793974131928,"version":"4.8.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Vestibular migraine (VM) and Meni\u00e8re\u2019s disease (MD) are characterized by episodes of vertigo of similar duration. It is well known that differentiation between both diseases is not always possible based only on the patient history, physical examination, and audiological testing. In addition, the quantification of the vestibular function can also be helpful since, among patients with MD, there is often a dissociation between a normal\/pseudo-normal video head impulse test (vHIT) and reduced caloric testing. The goal of this confirmatory study was to determine the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of this dissociation to differentiate between MD and VM as well as between MD and other vestibular diseases. We performed a retrospective analysis of 2,101 patients. The examination group consisted of 1,100 patients; of these, 627 (57%) had MD according to the diagnostic criteria of the B\u00e1r\u00e1ny Society and 473 (43%) had VM. The comparison group consisted of 1,001 patients with other peripheral, central, or functional vestibular disorders. Statistical analysis revealed the following findings for the dissociation: MD vs. VM: specificity: 83.5%, sensitivity: 58.9%, PPV: 82.6%, and NPV: 60.5%, and MD vs. all other vestibular disorders (VM plus others): specificity: 83.5%, sensitivity: 58.9%, PPV: 60.3%, and NPV: 82.7%. The dissociation between a normal vHIT and a reduced caloric response is due to the high specificity and PPV suited for the differentiation between MD and VM. This part of the study confirms previous findings in a large cohort of patients. When it comes to differentiating between MD and all observed vestibular disorders, if there is no dissociation, the diagnosis of MD is unlikely.<\/jats:p>","DOI":"10.3389\/fneur.2024.1449261","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T09:57:03Z","timestamp":1723629423000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["The dissociation between pathological caloric testing and a normal video head impulse test helps differentiate between Meni\u00e8re\u2019s disease, vestibular migraine, and other vestibular disorders: a confirmatory study in a large cohort of 2,101 patients"],"prefix":"10.3389","volume":"15","author":[{"given":"Vergil","family":"Mavrodiev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Strupp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Vinck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"van de Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Lehner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3233\/VES-150549","article-title":"Diagnostic criteria for Meniere\u2019s disease","volume":"25","author":"Lopez-Escamez","year":"2015","journal-title":"J Vestib Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.3233\/VES-2012-0453","article-title":"Vestibular migraine: diagnostic criteria","volume":"22","author":"Lempert","year":"2012","journal-title":"J Vestib Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"749","DOI":"10.3389\/fneur.2018.00749","article-title":"Simultaneous presentation of definite vestibular migraine and definite Meniere\u2019s disease: overlapping syndrome of two diseases","volume":"9","author":"Murofushi","year":"2018","journal-title":"Front Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s00405-018-5157-3","article-title":"Clinical manifestations of hydropic ear disease (Meniere\u2019s)","volume":"276","author":"Gurkov","year":"2019","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1212\/wnl.56.4.436","article-title":"The interrelations of migraine, vertigo, and migrainous vertigo","volume":"56","author":"Neuhauser","year":"2001","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1801845","DOI":"10.1155\/2016\/1801845","article-title":"Recent advances in the understanding of vestibular migraine","volume":"2016","author":"Sohn","year":"2016","journal-title":"Behav Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"944001","DOI":"10.3389\/fneur.2022.944001","article-title":"Auditory manifestations of vestibular migraine","volume":"13","author":"Shi","year":"2022","journal-title":"Front Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.3389\/fimmu.2019.01229","article-title":"Differential proinflammatory signature in vestibular migraine and Meniere disease","volume":"10","author":"Flook","year":"2019","journal-title":"Front Immunol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1016\/S1474-4422(13)70107-8","article-title":"Vestibular migraine: clinical aspects and pathophysiology","volume":"12","author":"Furman","year":"2013","journal-title":"Lancet Neurol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/00129492-200501000-00013","article-title":"Pathophysiology of Meniere\u2019s syndrome: are symptoms caused by endolymphatic hydrops?","volume":"26","author":"Merchant","year":"2005","journal-title":"Otol Neurotol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S71","DOI":"10.1007\/s00415-015-7930-1","article-title":"What is Meniere\u2019s disease? 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