The clinical characteristics and anatomical variations in patients with intractable unilateral Meniere’s disease with and without migraine

Abstract

BACKGROUND: Migraine is more common in Meniere’s disease patients, who have some certain anatomical variations. But there are limited studies focusing on the anatomical variations in patients with Meniere’s disease and migraine. OBJECTIVE: To explore the clinical and anatomical features in Meniere’s disease patients with and without migraine, determining whether the coexistence of migraine can be used as a basis for clinical subtyping of Meniere’s disease. METHODS: Ninety-five Meniere’s disease patients and ninety-five healthy subjects matched with age, sex were selected. A detailed questionnaire based on the diagnosis criteria of Meniere’s disease and migraine was designed. According to the CT scan, we divided the mastoid cell system of all the subjects into two types: well-pneumatization type and poor-pneumatization type. Meanwhile, the shortest distance between the sigmoid sinus and the posterior wall of the external acoustic canal was measured. RESULTS: Compared with those without migraine, Meniere‘s disease patients with migraine had a higher female comorbidity, poorer mastoid pneumatization, shorter distance between the sigmoid sinus and posterior wall of the external acoustic canal, longer history, higher frequency of vertigo attacks and better average hearing threshold. CONCLUSIONS: In our study, anatomical features as well as several clinical manifestations were proved to differ significantly between Meniere’s disease patients with and without migraine, indicating the coexistence of migraine may be one standard for the clinical subtyping of Meniere’s disease.

Association Between Meniere Disease and Migraine

“…13 There was a greater rate of migraine in female patients with MD, clinical manifestations of frequent vertigo attacks, better hearing levels, and specific anatomical features. 13 The large study population could potentiate the reciprocal association between MD and migraine in subgroups of this study. Although a significant association between MD and migraine was observed in all subgroups, the middle-aged, male, and comorbid conditions of hyperglycosemia and hypercholesterolemia subgroups showed a stronger association between the 2 diseases in this study.…”

“…The bidirectional associations between MD and migraine were valid in all subgroups. In contrast, a cross-sectional study examined the specific features of patients with MD combined with migraine . There was a greater rate of migraine in female patients with MD, clinical manifestations of frequent vertigo attacks, better hearing levels, and specific anatomical features .…”

“…Additionally, several studies have proposed an association of MD with migraine . Meniere and several previous authors described migrainous headache as a frequent accompanying symptom of MD .…”

“…12 Additionally, several studies have proposed an association of MD with migraine. [13][14][15][16] Meniere and several previous authors described migrainous headache as a frequent accompanying symptom of MD. [15][16][17][18] A prospective study reported that the prevalence of migraine was higher in 78 patients with MD than in 78 matched patients (56% vs 25%).…”

Non-contrast MRI of Inner Ear Detected Differences of Endolymphatic Drainage System Between Vestibular Migraine and Unilateral Ménière's Disease

“…The following five distinctive clinical subtypes have been identified by the Ménière's Disease Consortium (61): Type 1 included patients without a familial history of MD, migraine, or autoimmune comorbidity; Type 2 had delayed MD characterized by SNHL which antedated the vertigo episodes; Type 3 included all familial cases of MD; Type 4 was associated with migraine with or without aura, and Type 5 was defined by a concurrent autoimmune disorder (61). Recently, Diao et al found that some radiological variables differed between patients with MD with and without migraine, including the poorer mastoid pneumatization and the shorter distance between the sigmoid sinus and posterior wall of the external acoustic canal (62). Then, it is reasonable to suppose that the anatomical variations may play inconsistent roles in different subtypes of unilateral MD.…”