Characteristics of multifrequency vestibular evoked myogenic potentials tuning in ménière's disease and vestibular migraine.

Abstract

Objective: Diagnostic criteria for Vestibular Migraine (VM) and Ménière's Disease (MD) overlap considerably, complicating accurate diagnoses in patients with headaches, vertigo, hearing loss, aural fullness, and tinnitus. This study assesses the utility of multifrequency vestibular evoked myogenic potentials (VEMPs) in differentiating MD from VM.

Study sample: The research included 49 MD and 32 VM patients from April to June 2024. Each patient underwent a comprehensive interview and symptom documentation, followed by detailed auditory and vestibular function evaluations, including multifrequency VEMPs. We performed data analysis using IBM SPSS Statistics 20.0. Data normality was assessed with the Shapiro-Wilk test. Group comparisons were conducted using the Mann-Whitney U test, Kruskal-Wallis test, and Chi-square test.

Results: VEMPs showed heightened response rates at 750 and 1000 Hz. Notably, in affected ears of MD, the elicitation rate of ocular VEMPs (oVEMP) increased from 55% to 67%, and in VM patients, it escalated from 56% to 78%. Cervical VEMPs (cVEMP) amplitude decreased with higher frequencies (P < 0.05), while oVEMP amplitude increased, though not significantly (P > 0.05). Slope graphs illustrated the overall tuning of VEMPs and analysed the correlation between VEMPs tuning and subjective symptoms. Significantly, oVEMP tuning proved valuable in accurately reflecting early-stage MD (stages I and II).

Conclusion: This study underscores the crucial role of multifrequency VEMPs in enhancing the diagnostic processes for MD and VM. By delineating distinct response patterns across various frequencies, VEMPs not only confirm their diagnostic significance but also improve their ability to differentiate between MD and VM. These findings highlight the potential of VEMPs to facilitate more precise and effective clinical interventions by distinguishing between vestibular disorders across frequencies.