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Prevalence and preferred medication for vestibular migraine in Menière’s disease: a multicenter retrospective cohort study in Korea
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Dong-Han Lee, Hong Ju Park, Kyu-Sung Kim, Hyun Ji Kim, Jae-Yong Byun, Min-Beom Kim, Minbum Kim, Myung-Whan Suh, Jae-Hyun Seo, Jong Dae Lee, Eun-Ju Jeon, Myung Hoon Yoo, Seok Min Hong, Sung-Kwang Hong, Hyo-Jeong Lee, Jung Woo Lee, Se-Joon Oh, Hyun Ah Kim, Hyung Lee, Eek-Sung Lee, Eun-Jin Kwon, Seong-Hae Jeong, Jeong-Yoon Choi, Chang-Hee Kim
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Res Vestib Sci. 2024;23(2):37-45. Published online June 14, 2024
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DOI: https://doi.org/10.21790/rvs.2024.005
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 Abstract
 PDF Supplementary Material
- Objectives
The aim of this study is to categorize headaches associated with definite Menière’s disease (MD) according to diagnostic criteria, to determine their prevalence, and to investigate the preferred medication across participating centers.
Methods
Patients diagnosed with definite MD at 17 university hospitals in otolaryngology or neurology departments in Korea between January 1, 2021 to December 31, 2021 were retrospectively included. Data on the presence of accompanying vestibular migraine (VM), migraine or non-migraine headaches, and clinical information were collected. A survey was conducted to assess preferences for treatment drugs for vertigo and headache control in MD patients with headache.
Results
A total of 435 definite MD patients were included, with a mean age of 57.0±14.9 years. Among them, 135 (31.0%) had accompanying headaches, of whom 48 (11.0% of all definite MD patients) could be diagnosed with VM. The prevalence of comorbid VM (definite and probable) was significantly higher in females (41 of 288, 14.2%) than in males (7 of 147, 4.8%) (p<0.05). There was no significant difference in the prevalence of comorbid VM between unilateral and bilateral MD patients (10.8% and 13.6%, respectively) (p > 0.05). Benzodiazepines, antihistamines, and antiemetics were mainly preferred for acute vertigo control, while nonsteroidal anti-inflammatory drugs, acetaminophen, and triptans were preferred for acute headache control, and topiramate, propranolol, and calcium channel blockers were mainly preferred for headache prevention.
Conclusions
VM is not uncommon in patients with definite MD in Korea. Further research is needed to understand the differences in headache prevalence and preferred medications across different centers.
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How to Evaluate Associated Symptoms in Dizziness: Hyperacusis, Otorrhea and Other Ear Symptoms
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Myung Hoon Yoo, Hong Ju Park
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Res Vestib Sci. 2013;12:S24-S30. Published online June 1, 2013
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Abstract
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- A carefully obtained history is most important when evaluating a dizzy patient. Specific symptoms guide the examination and workup, and it is critical for the physician to focus on associated symptoms, in addition to the dizziness complaint itself. Hyperacusis accompanied with vertigo, may be a sign of superior canal dehiscence syndrome, Meniere’s disease, migrainous vertigo, perilymphatic fistula, labyrinthine concussion, and Ramsay Hunt syndrome. Otorrhea, usually a sign of otitis media, can suggest labyrinthine fistula or labyrinthitis as a cause of dizziness. This review describes the evaluation of hyperacusis, autophony, otorrhea and other otologic symptoms (except hearing loss and tinnitus) in patients with dizziness, and related causes of dizziness.
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