Migraine and Meniere's disease.

Timothy C. Hain, MD • Page last modified: September 7, 2019

There is some speculation that Meniere's and Migraine are two faces of the same indistinguishable condition. The evidence is against this idea because they don't overlap most of the time. In our dizzy practice in Chicago, as of 9/2019, we had 1161 patients diagnosed with Meniere's disease, of whom 293 also carried a diagnosis of Migraine. Thus this works out to about 25%, including 89 men and 202 women. Note that 25% is a little larger than the population prevalence of Migraine (about 15%), so there are roughly more persons with migraine than would be expected in persons with menieres. To work this out more precisely one would have to adjust for age and gender.

In the literature, the published studies of Meniere/migraine generally contain far less subjects than our clinic database (see below).

There are some substantial methodological problems here as "migraine" is a condition "diagnosed" from subjective symptoms -- i.e. someone who reads the Wikipedia page on migraine, could in theory, have "migraine". Meniere's disease is rather similar, but it does include a requirement for hearing loss, which presumably narrows the field.

Another problem is that "Meniere's", may be a varying degrees of certainty (like Migraine).

Furthermore, there is almost certainly a sample bias - - individuals referred to our practice (we are oto-neurologists), likely have more neurological symptoms (i.e. headache), than patients seen in an otolaryology practice, and there are also many other potential biasing features.

Nevertheless, we think that 25% is "as good as it gets" in 2019, for the coincidence of migraine and Meniere's, mainly because of the large sample.

With respect to the entity called "vestibular migraine", defined by a committee called the "International Headache Society", we are not so sure that all of our Meniere's patients are a fit -- the criteria for "vestibular migraine" are so complex that it is difficult to know if any particular patient has "jumped through all of the hoops" and therefore qualified to be officially designated as "vestibular migraine". The term "migraine associated vertigo" would however still seem to be generally useful.

Literature review:

MD = Meniere's disease, MMD = Menieres +Migraine, VN = Vestibular Neuritis.