VESTIBULAR MIGRAINE VS. MÉNIÈRE’S DISEASE

Abstract

Introduction: Vestibular migraine and Ménière’s disease are significant clinical conditions in the differential diagnosis of vestibulopathies, as both present with recurrent episodes of vertigo, nausea, and a compromised quality of life. Vestibular migraine is associated with a history of migraine, sensitivity to light and sound, headache, and intolerance to movement. In contrast, Ménière’s disease is characterized by vertigo attacks accompanied by fluctuating sensorineural hearing loss, tinnitus, and a sensation of aural fullness. The similarity between their clinical manifestations complicates diagnostic differentiation, particularly in the early stages. Objective: This systematic literature review aimed to analyze the clinical, diagnostic, and pathophysiological differences between vestibular migraine and Ménière’s disease, while considering the primary challenges in differential diagnosis and available treatment options. Methodology: The review was structured according to the PRISMA checklist, incorporating scientific articles published over the last ten years, identified via the PubMed, SciELO, and Web of Science databases. Five descriptors were used—“Vestibular Migraine,” “Ménière’s Disease,” “Vertigo,” “Differential Diagnosis,” and “Hearing Loss”—combined using Boolean operators. Inclusion criteria encompassed studies published in scientific journals that directly addressed both conditions and were available in full text in either Portuguese or English. Duplicate studies, publications unrelated to the topic, and articles lacking relevant clinical or diagnostic information were excluded. Results: The analyzed studies demonstrated that clinical history, audiological evaluation, and the characterization of the attacks are essential for distinguishing between these two conditions. Vestibular migraine showed a stronger association with photophobia, phonophobia, and a history of migraine, whereas Ménière’s disease was characterized by more significant auditory impairment, specifically fluctuating hearing loss. However, the overlap of symptoms and the possibility of the conditions coexisting necessitated an individualized assessment. Treatment also varied according to the diagnosis, encompassing preventive measures for migraine, as well as strategies aimed at managing vestibular and auditory symptoms in Ménière’s disease. Conclusion: Differentiating between these conditions relied on integrating clinical, audiological, and longitudinal findings. Recognizing their specific characteristics facilitated more accurate diagnoses, tailored treatment plans, and an improved quality of life.