Vestibular Migraine, Meniere’s, or Benign Recurrent Vertigo?

Vestibular migraine (VM) and Meniere’s Disease (MD) are fairly common diagnoses with established criteria for diagnosis and classification. Benign recurrent vertigo (BRV), although first described in 1979, is lesser known and, to date, does not have established criteria for diagnosis. Descriptions of BPV include a history of multiple attacks of vertigo with nausea, vomiting, and no aural or neurological symptoms. With no known etiology, some believe BPV to be a variant of either VM or MD.

Researchers used a prospective cohort design to determine if there were significant differences in the number of vertigo attacks, medication use, and ratings on the Hospital Anxiety and Depression Scale (HADS) between groups over three years. Participants were surveyed every six months for 36 months.

Results indicate that medication use was consistently higher in the MD group. The MD group also had a significantly higher (worse) HADS score at enrollment. The MD group had the most positive change in the HADS compared to the others over time. All groups showed a reduction in the number of attacks over time, with no differences between groups. The authors note that no participant was later reclassified into a different group (i.e., BRV meeting criteria for VM or MD).

Clinically, it is important to understand the recognized diagnostic classifications for proper patient management. While VM is gaining recognition and more patients are being identified, there are some patient’s that might not meet the diagnostic criteria for either VM or MD and may be better classified as BRV.

Reference

van Leeuwen RB, Colijn C, van Esch BF, Schermer Tjard R. (2022) Benign recurrent vertigo: The course of vertigo attacks compared to patients with Menière’s Disease and vestibular migraine. Front Neurol 13: 817812. DOI=10.3389/fneur.2022.817812