Research in Vestibular Science

Original Article

Prevalence and preferred medication for vestibular migraine in Menière’s disease: a multicenter retrospective cohort study in Korea: 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; Res Vestib Sci. 2024;23(2):37-45. Published online June 14, 2024; 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.

Essay

The XXXI Bárány Society Meeting: An Attendance Report: Dong-Han Lee, Myung-Whan Suh; Res Vestib Sci. 2022;21(2):63-65. Published online June 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.2.63

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Review

Clinical Application and Updates on Vestibular Evoked Myogenic Potential: Proposal for Future Development in Vestibulopathy: Myung-Whan Suh, Jinil Kim; Res Vestib Sci. 2018;17(3):71-78. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.71

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Abstract PDF

Both cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) are irreplaceable tools in the current vestibular science, but they have many drawbacks. For example, the test-retest reliability of the asymmetry ratio is inadequate for both tests. The American Academy of Neurology noted that there is insufficient evidence to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle. One of the most important factors underlying the variability of cVEMP seems to be the control of, and compensation for, baseline muscle contraction power. Reasons for variability in oVEMP include a poor signal to noise ratio, the angle of superior gaze, effective and controlled presentation of stimuli, intracranial pressure, and electrode location. Many of these shortcomings could be improved by further development of recording methods and devices. This article examines the reasons for the insufficient reliability of VEMP and proposes avenues for improvement of VEMP recording systems.

Citations

Citations to this article as recorded by

Difference of Cervical Vestibular Evoked Myogenic Potentials between Bone-Conduction and Air-Conduction in Patients with Nonspecific Dizziness
Yong-Hwi An, Jung Ho Choi, Seung Yeon Jeon, Hyun Joon Shim
Research in Vestibular Science.2022; 21(4): 93. CrossRef
A Case of Patient with Acute Peripheral Vestibulopathy Involving Isolated Posterior Semicircular Canal
Sang Kwon Im, Mee Hyun Song, Ja Won Gu, Dae Bo Shim
Research in Vestibular Science.2019; 18(4): 128. CrossRef

Clinical Application and Updates on Vestibular Evoked Myogenic Potential: Proposal for Future Development in Vestibulopathy: Myung-Whan Suh, Jinil Kim; Received August 12, 2018 Accepted August 28, 2018 Published online August 28, 2018; [Accepted]

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2 Download

Abstract: Both cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) are irreplaceable tools in the current vestibular science, but they have many drawbacks. For example, the test–retest reliability of the asymmetry ratio is inadequate for both tests. The American Academy of Neurology noted that there is insufficient evidence to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle. One of the most important factors underlying the variability of cVEMP seems to be the control of, and compensation for, baseline muscle contraction power. Reasons for variability in oVEMP include a poor signal to noise ratio, the angle of superior gaze, effective and controlled presentation of stimuli, intracranial pressure, and electrode location. Many of these shortcomings could be improved by further development of recording methods and devices. This article examines the reasons for the insufficient reliability of VEMP and proposes avenues for improvement of VEMP recording systems.

Case Report

Central Apogeotropic Direction Changing Positional Nystagmus due to Fourth Ventricle Mass Mimicking Horizontal Canal Cupulolithiasis Benign Paroxysmal Positional Vertigo: Hyoung Won Jeon, Yae-Ji Shim, Moo-Kyun Park, Myung-Whan Suh; Res Vestib Sci. 2016;15(3):84-88. Published online September 15, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.3.84

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Abstract PDF

In some dizzy patients the apogeotropic direction changing positional nystagmus (DCPN) can be caused by a central disorder such as a mass lesion near the fourth ventricle or infaction. We have recently encountered a patient who showed a central DCPN mimicing a horizontal canal cupulolithiasis benign paroxysmal positional vertigo (BPPV). A 4.1 cm sized tumor was filling the fourth ventricle before the operation. When the head was turned to the left side vigorous right beting nystagmus was found. When the head was turned to the right side vigorous left beting nystagmus was found. But unlinke the typical horizontal canal BPPV, bowing and lying down position did not elicit any nystagmus. In order to see if the central DCPN was a transient finding or a persistent finding, we checked the nystagmus 3 weeks after the first testing. The same pattern of nystagmus was found again. The video head impulse test gain of all six canals were within the normal limit. In this article we discuss the points how to suspect a central DCPN in such cases.

Citations

Citations to this article as recorded by

The Effect, Compliance and Satisfaction of Customized Vestibular Rehabilitation: A Single Center Experience
Hyung Lee, Hyun Ah Kim
Research in Vestibular Science.2019; 18(1): 14. CrossRef
Factors Associated with Patient Satisfaction in Customized Vestibular Exercise: A Pilot Study
Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi
Research in Vestibular Science.2019; 18(3): 71. CrossRef

Symposium I

Associated Symptoms in Dizziness: Hearing Loss and Tinnitus: Mi Na Park, Myung-Whan Suh; Res Vestib Sci. 2013;12:S16-S23. Published online June 1, 2013

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Abstract PDF: Dizziness is one of the most common complaint leading patients to visit their primary care physicians in older people. Despite its frequency, symptoms of dizziness can be difficult for the physician to categorize. Also many dizzy patients have hearing loss. The evaluation of patients with dizziness depends on not only the history of dizziness, physical findings but also basic laboratory tests such as audiometry, electrocochleogram, Cochlear hydrops analysis masking procedure, auditory brainstem response. Based on these considerations, this article outlines the interpretation of basic audiologic tests which is fundamental in evaluating dizzy patients.

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