Vestibular Testing and Rehabilitation Differences Between Vestibular Migraine, Ménière's Disease, and Dually-Diagnosed Patients

Sunday, September 29, 2024

1:18 PM – 1:24 PM EDT

Location: MBCC, 231

Disclosure(s):

Susmita Chennareddy, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Andrea Feghali, NP:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Maura KELLY Cosetti, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Enrique R. Perez, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Little consensus exists on when to employ vestibular function tests in patients with Meniere’s disease (MD) and vestibular migraine (VM). This study describes trends in utilization of videonystagmography (VNG), vestibular evoked myogenic potential (VEMP), video head impulse test (VHIT), rotary chair, and vestibular rehabilitation among patients with MD, VM, or both.

Methods: This retrospective cohort study was conducted at an urban, academic, tertiary referral center among patients who were seen between September 2021 and September 2023 for vestibular migraine or Meniere’s disease. Vestibular function test, vestibular rehabilitation visit, demographic, and clinical data were collected. Chi-square and one-way analysis of variance tests were used for statistical analysis.

Results: A total of 338 records were reviewed (37 dual-diagnosis, 226 MD-only, and 75 VM-only). Dual-diagnosis patients were significantly more likely to receive vestibular tests (76% dual, 41% MD-only, 47% VM-only; p < 0.001) and on average received more (1.19) than single-diagnosis cohorts (0.62 MD-only, 0.71 VM-only; p = 0.002). Dual-diagnosis patients were significantly more likely to receive VNG (p = 0.002) and rotary chair (p < 0.001) tests than single-diagnosis patients, but there was no difference in VEMP and VHIT test rates between cohorts. VM-only patients were significantly more likely to receive vestibular rehabilitation compared to the MD-only cohort (41% VM-only vs 16% MD-only, p < 0.001), with no significant differences in vestibular rehabilitation rates between other groups.

Conclusions: Diagnosing and managing MD and VM is challenging due to overlapping symptomatology. In this study, patients with dual diagnoses were more likely to receive vestibular tests compared to single-diagnosis patients, but dual-diagnosis patients did not experience increased rates of vestibular rehabilitation. Future studies will aim to investigate differences in audiological and vestibular test outcomes between single and dual-diagnosis cohorts.

Presenting Author(s)

Susmita Chennareddy, BA

Medical Student
Icahn School of Medicine at Mount Sinai
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jennifer Ren, BA

Medical Student
Icahn School of Medicine At Mount Sinai
New York, New York, United States

Disclosure information not submitted.

Co-Author(s)

AF

Andrea Feghali, NP

Nurse Practitioner
New York Eye and Ear Infirmary of Mount Sinai
new york, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jennifer L. Kelly, PT, DPT, NCS

Administrative Director Ear Institute
New York Eye and Ear Infirmary
New York, NY, United States

Disclosure information not submitted.
SJ

Spencer Johnson, BA

Icahn School of Medicine at Mount Sinai, United States

Disclosure information not submitted.
Maura Cosetti, MD

Associate Professor, Director, Ear Institute of New York Eye and Ear Infirmary of Mount Sinai
Ear Institute of New York Eye and Ear Infirmary of Mount Sinai
New York, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

EP

Enrique R. Perez, MD, MBA

Assistant Professor
New York Eye and Ear Infirmary of Mount Sinai
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.