Photo Credit: Rasi Bhadramani

The dissociation between pathological caloric testing and a normal video head impulse test can differentiate between Meniere disease (MD) and vestibular migraine (VM), according to a study published in Frontiers in Neurology. Researchers examined the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the dissociation between a normal/pseudo-normal video head impulse test and reduced caloric testing to differentiate between MD and VM in a retrospective analysis of 2,101 patients. The examination group included 1,100 patients: 57% and 43% had MD and VM, respectively. The comparison group included 1,001 patients with other peripheral, central, or functional vestibular disorders. The researchers found that for differentiating MD versus VM, the specificity was 83.5%, sensitivity was 58.9%, PPV was 82.6%, and NPV was 60.5% for the dissociation. The specificity, sensitivity, PPV, and NPV for differentiating MD from all other vestibular disorders were 83.5%, 58.9%, 60.3%, and 82.7%, respectively.