Table 3.
Clinical data in patients with follow-up recordings of vestibular evoked myogenic potentials (VEMPs) from Figs. 2 and 3
| Diagnosis and gender | Disease duration (years) | Symptoms | Audio-vestibular test results | |||
|---|---|---|---|---|---|---|
| Baseline | Baseline | Follow-up | Baseline | Follow-up | ||
| VM 1 |
pVM f |
7 | Spontaneous and positional vertigo attacks for minutes, clustering over several days; 1x/month; accompanying symptoms: nausea, vomiting, photo-/phonophobia, visual aura, sometimes frontal headache; no history of migraine | Treatment with propranolol (5 mg TID); same frequency of attacks, but reduced severity | SVV tilt to the left (5°), normal PTA, normal calorics, normal vHIT | Recovery of SVV tilt, slightly saccadic smooth pursuit |
| VM 2 |
dVM m |
1 | Spontaneous vertigo attacks (ca. 15 min), 2-3x/month; accompanying symptoms: nausea, frontal headache, photophobia; positive migraine history | Moderate daily physical activity (30 min); 0–1 attacks/month from Aug to Oct 2016; 2 attacks/month from Nov 2016 to Jan 2017 | Normal PTA, normal vHIT, right HSN, no hydrops in inner ear MRI | Variable caloric asymmetry (first right, then left hypo-excitability), no HSN |
| MD 1 |
dMD left m |
1 | Spontaneous vertigo attacks (up to 12 h), 2x/week; accompanying symptoms: nausea, ear fullness, tinnitus, hearing loss on the left |
Apr 2016: patient treated with betahistine dihydrochloride 144 mg TID since Dec 2015, no attacks. Temporary increase in attack frequency in May 2016 (2x/week) and Jan 2017 (1–2×/month), progressive hearing loss and chronic tinnitus on the left. ⇒ Symptom-based adjustment of medication (up to 288 mg betahistine TID) Aug 2017–May 2019: no vertigo attacks, sometimes imbalance. ⇒ Betahistine 96 mg TID |
PTA: low-frequency hearing loss on the left, calorics: hypo-excitability on the left (42%), normal vHIT | PTA: progressive low-frequency hearing loss on the left, calorics: progressive hypoexcitability on the left (60%) |
| MD 2 |
dMD left m |
8 | Spontaneous vertigo attacks (hours) with ear fullness, tinnitus and hearing loss on the left; Tumarkin drop attacks (seconds) without accompanying ear symptoms |
Oct 2015–Dec 2017: patient treated with betahistine dihydrochloride 24 mg TID, no vertigo attacks, no Tumarkin attacks, occasional imbalance. ⇒ Betahistine 24 mg BID Dec 2017–Oct 2019: 3 short attacks with vertigo or leftward sway (sec–min), no falls, progressive hearing loss and tinnitus on the left. ⇒ Betahistine 96 mg TID |
PTA: low-frequency hearing loss on the left, normal calorics, normal vHIT | PTA: pantonal hearing loss on the left, normal calorics, normal vHIT |
BID two times a day, dMD definite Menière’s disease, dVM definite vestibular migraine, f female, HSN head-shake nystagmus, m male, MRI magnetic resonance imaging, pVM probable vestibular migraine, PTA pure tone audiogram, SVV subjective visual vertical, TID three times a day, vHIT video head impulse test