Distinguishing Meniere's disease from vestibular migraine: A comprehensive review of symptoms and diagnostic insights
- 1Department of Geriatric Medicine, Affiliated Hospital of Shandong Second Medical University, China
Abstract
Meniere's disease and vestibular migraine are common episodic vestibular syndromes whose overlapping vertigo, auditory, and migraine-associated features can complicate differential diagnosis. In this narrative review, we compared the diagnostic criteria, symptom patterns, pathophysiology, and complementary test findings of these syndromes. Vestibular migraine is diagnosed clinically based on recurrent vestibular symptoms, migraine history, temporal association with migraine features, and exclusion of alternative causes; audiological and vestibular evaluations are not required. In contrast, diagnosis of definite Meniere’s disease is made if the patient exhibits episodic vertigo with audiometrically documented low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms. Therefore, serial audiometry plays a direct role in the diagnosis of Meniere’s disease, whereas caloric testing, video head impulse testing, vestibular-evoked myogenic potentials, and hydrops imaging provide supportive rather than standalone discriminatory evidence. Emerging studies have identified distinct cytokine and immune signatures between Meniere's disease and vestibular migraine. In one research cohort, an interleukin-1 beta, CC motif chemokine ligand 3, CC motif chemokine ligand 22, and CXC motif chemokine ligand 1 cytokine panel has demonstrated high discriminatory performance (area under the curve = 0.995), whereas multiomic studies have identified divergent immune-cell pathways. However, external validation and standardized clinical thresholds are required before these approaches can be adopted for routine diagnosis. In practice, differentiation should be anchored in longitudinal history and consensus criteria, supplemented by serial hearing assessment and targeted vestibular or imaging studies when clinically indicated.
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BibTeX
@article{li2026distinguishing,
title = {{Distinguishing Meniere's disease from vestibular migraine: A comprehensive review of symptoms and diagnostic insights}},
author = {Han Li and Xinjun Yu and Wenchao Li},
journal = {The Journal of International Medical Research},
year = {2026},
month = sep,
doi = {10.1177/03000605261491433},
url = {https://doi.org/10.1177/03000605261491433},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Distinguishing Meniere's disease from vestibular migraine: A comprehensive review of symptoms and diagnostic insights
AU - Han Li
AU - Xinjun Yu
AU - Wenchao Li
PY - 2026
DA - 2026/09/30
JO - The Journal of International Medical Research
DO - 10.1177/03000605261491433
UR - https://doi.org/10.1177/03000605261491433
AB - Meniere's disease and vestibular migraine are common episodic vestibular syndromes whose overlapping vertigo, auditory, and migraine-associated features can complicate differential diagnosis. In this narrative review, we compared the diagnostic criteria, symptom patterns, pathophysiology, and complementary test findings of these syndromes. Vestibular migraine is diagnosed clinically based on recurrent vestibular symptoms, migraine history, temporal association with migraine features, and exclusion of alternative causes; audiological and vestibular evaluations are not required. In contrast, diagnosis of definite Meniere’s disease is made if the patient exhibits episodic vertigo with audiometrically documented low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms. Therefore, serial audiometry plays a direct role in the diagnosis of Meniere’s disease, whereas caloric testing, video head impulse testing, vestibular-evoked myogenic potentials, and hydrops imaging provide supportive rather than standalone discriminatory evidence. Emerging studies have identified distinct cytokine and immune signatures between Meniere's disease and vestibular migraine. In one research cohort, an interleukin-1 beta, CC motif chemokine ligand 3, CC motif chemokine ligand 22, and CXC motif chemokine ligand 1 cytokine panel has demonstrated high discriminatory performance (area under the curve = 0.995), whereas multiomic studies have identified divergent immune-cell pathways. However, external validation and standardized clinical thresholds are required before these approaches can be adopted for routine diagnosis. In practice, differentiation should be anchored in longitudinal history and consensus criteria, supplemented by serial hearing assessment and targeted vestibular or imaging studies when clinically indicated.
SN - 0300-0605
SN - 1473-2300
ER -