How does the duration of vertigo help to differentiate between migraine-associated vertigo and Ménière disease?

Updated: Jan 18, 2019
  • Author: Aaron G Benson, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

When vertigo is present, it may be indistinguishable from the spontaneous vertigo of Ménière disease. One clue that the vertigo is not of the Ménière type is that the vertigo of migraine-associated vertigo may last longer than 24 hours. In fact, a rocking sensation may be a continuous feeling for many weeks to months. In contrast, the vertigo of Ménière disease typically does not last longer than 24 hours. (See Table 2).

Table 2. A Comparison of the Symptoms of Migraine-Associated Vertigo and Ménière Disease (Open Table in a new window)

Symptom

Migraine-Associated Vertigo

Ménière Disease

Vertigo

May last >24h

Lasts up to 24h

Sensorineural hearing loss

Very uncommon; when present, often low frequency; very rarely progressive; may fluctuate in cases of basilar migraine

Nearly always progressive; most often unilateral; may be bilateral; fluctuation is common

Tinnitus

May be unilateral or bilateral; rarely obtrusive

May be unilateral or bilateral; often of significant intensity

Photophobia

Often present; may or may not be associated with dizziness

Never present unless a concurrent history of migraine exists


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