前庭性偏头痛(VM)和梅尼埃病(MD)的特征是持续时间相似的眩晕发作。众所周知,仅根据患者病史,并不总是可以区分两种疾病。体检,和听力学测试。此外,前庭功能的量化也有帮助,因为,在MD患者中,正常/伪正常视频头脉冲测试(vHIT)和降低热量测试之间通常存在分离。这项验证性研究的目的是确定敏感性,特异性,以及这种分离的阳性和阴性预测值(PPV和NPV),以区分MD和VM以及MD和其他前庭疾病。我们对2,101例患者进行了回顾性分析。检查组由1100名患者组成;其中,根据Bárány协会的诊断标准,627(57%)患有MD,473(43%)患有VM。对照组包括1,001例其他外周患者,中央,或功能性前庭疾病。统计分析揭示了解离的以下发现:MD与VM:特异性:83.5%,灵敏度:58.9%,PPV:82.6%,净现值:60.5%,和MDvs.所有其他前庭疾病(VM加其他):特异性:83.5%,灵敏度:58.9%,PPV:60.3%,净现值:82.7%。正常vHIT和降低的热量响应之间的解离是由于适合于MD和VM之间的区分的高特异性和PPV。该研究的这一部分证实了先前在大量患者队列中的发现。在区分MD和所有观察到的前庭疾病时,如果没有分离,MD的诊断可能性不大.
Vestibular migraine (VM) and Menière\'s 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 Bárány 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.