{"id":17466,"date":"2026-01-26T16:17:31","date_gmt":"2026-01-26T15:17:31","guid":{"rendered":"https:\/\/ivrt.de\/?p=17466"},"modified":"2026-02-06T17:56:27","modified_gmt":"2026-02-06T16:56:27","slug":"vestibulaere-migraene-oder-morbus-meniere-lmu-studie-zeigt-sieben-merkmale-helfen-bei-der-unterscheidung","status":"publish","type":"post","link":"https:\/\/ivrt.de\/en\/studien-evidenz\/vestibulaere-migraene-oder-morbus-meniere-lmu-studie-zeigt-sieben-merkmale-helfen-bei-der-unterscheidung\/","title":{"rendered":"Vestibular Migraine or M\u00e9ni\u00e8re\u2019s Disease? LMU study shows: seven features help differentiate"},"content":{"rendered":"<p><strong>For Healthcare Professionals:<\/strong><\/p>\n\n\n\n<p>Vestibular migraine (VM) and M\u00e9ni\u00e8re\u2019s disease (MD) are common causes of recurrent vertigo attacks\u2014and are clinically difficult to distinguish. This LMU study shows which features separate them best and where current diagnostic criteria (ICVD) reach their limits.<\/p>\n\n\n\n<p>\ud83d\udd17Huppert D, Grill E, Becker-Bense S, Zwergal A, Strobl R. Diagnostic challenges in vestibular migraine-clinical differentiation from Meni\u00e8re&#8217;s disease and discrepancies with current classification criteria. J Neurol. 2025 Aug 5;272(9):558.<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40762827\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Original study<\/strong><\/a><\/p>\n\n\n\n<p><strong>Study design:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Site: LMU Munich (German Center for Vertigo and Balance Disorders, DSGZ)<\/li>\n\n\n\n<li>Participants: 276 patients (188 VM, 88 MD)<\/li>\n\n\n\n<li>Methods: history, audiometry, caloric testing, video head impulse test (vHIT), oculomotor tests<\/li>\n\n\n\n<li>Aim: identify clinical and instrumental features to differentiate VM and MD<\/li>\n<\/ul>\n\n\n\n<p><strong>Key results<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>VM: more common in women (72%), earlier onset (mean ~40 years)<\/li>\n\n\n\n<li>MD: more common in men (49%), later onset (mean ~50 years)<\/li>\n\n\n\n<li>M\u00e9ni\u00e8re: typical spinning vertigo, tinnitus, hearing problems, nausea<\/li>\n\n\n\n<li>Vestibular migraine: more frequent headaches, light sensitivity, swaying\/rocking dizziness<\/li>\n\n\n\n<li> Objective tests: MD more often showed caloric asymmetries and lower vHIT gain values<\/li>\n\n\n\n<li>Caloric\u2013vHIT dissociation (abnormal calorics, normal vHIT) suggests MD<\/li>\n\n\n\n<li>Seven key criteria (86% accuracy): hearing problems, age, vomiting, caloric side difference, postural instability, tinnitus, headache (see figure below)<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"696\" height=\"564\" src=\"https:\/\/ivrt.de\/wp-content\/uploads\/2026\/01\/Wissensblog-14-text-1.png\" alt=\"\" class=\"wp-image-17469\" srcset=\"https:\/\/ivrt.de\/wp-content\/uploads\/2026\/01\/Wissensblog-14-text-1.png 696w, https:\/\/ivrt.de\/wp-content\/uploads\/2026\/01\/Wissensblog-14-text-1-300x243.png 300w, https:\/\/ivrt.de\/wp-content\/uploads\/2026\/01\/Wissensblog-14-text-1-15x12.png 15w\" sizes=\"(max-width: 696px) 100vw, 696px\" \/><\/figure>\n\n\n\n<p><strong>\u201cSuspected VM\u201d \u2013 when criteria don\u2019t fit<\/strong><\/p>\n\n\n\n<p>About one third of VM cases did not fully meet ICVD criteria but were classified as VM by experts. Main reasons were atypical headache patterns (e.g., bilateral or pressure-like pain), a low number of attacks, differing accompanying symptoms, or subtle central oculomotor findings.<\/p>\n\n\n\n<p><strong><strong>Clinical Relevance<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Not every patient matches the textbook picture\u2014rigid criteria can easily lead to misdiagnosis.<\/li>\n\n\n\n<li>The best differentiation comes from combining history, caloric testing, vHIT, and clinical observation.<\/li>\n\n\n\n<li>\u201cSuspected VM\u201d should be taken seriously to avoid treatment delays.<\/li>\n<\/ul>\n\n\n\n<p><strong>Conclusion for Practice<\/strong><\/p>\n\n\n\n<p>Vestibular migraine and M\u00e9ni\u00e8re\u2019s disease can be reliably distinguished using a small set of clinical and instrumental features. Structured history-taking, combined testing, and an open mind for atypical courses are essential.<\/p>\n\n\n\n<p><strong>\ud83d\udc49 Are you interested in a comprehensive further training in <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/vestibulaere-rehabilitationstherapie-und-gleichgewichtstraining\/\" data-type=\"post\" data-id=\"8932\" target=\"_blank\" rel=\"noreferrer noopener\">vestibular rehabilitation<\/a> and how you can provide therapeutic care and treatment for both conditions to help patients with dizziness faster and more safely?<\/strong><\/p>\n\n\n\n<p>Current further education opportunities can be found in the <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT Course search<\/a>.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>For Patients \u2013 Easy to Understand<\/strong><\/p>\n\n\n\n<p><strong><strong><strong>Vestibular Migraine or M\u00e9ni\u00e8re\u2019s? Why both can feel similar\u2014and yet are different<\/strong><\/strong><\/strong><\/p>\n\n\n\n<p>Two common causes of recurring vertigo attacks are vestibular migraine and M\u00e9ni\u00e8re\u2019s disease. They can feel similar\u2014but they arise for different reasons and often need different treatments.<br><br>\ud83d\udcc4 Huppert D, Grill E, Becker-Bense S, Zwergal A, Strobl R. Diagnostic challenges in vestibular migraine-clinical differentiation from Meni\u00e8re&#8217;s disease and discrepancies with current classification criteria. J Neurol. 2025 Aug 5;272(9):558. doi: 10.1007\/s00415-025-13291-x. PMID: 40762827; PMCID: PMC12325411.<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40762827\/\" data-type=\"link\" data-id=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\" target=\"_blank\" rel=\"noreferrer noopener\">Original study<\/a><\/p>\n\n\n\n<p><strong>What does the new study show?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>M\u00e9ni\u00e8re\u2019s: more often spinning vertigo, tinnitus, and hearing loss<\/li>\n\n\n\n<li>Vestibular migraine: often headache, light sensitivity, or a pressure-like feeling in the head<\/li>\n\n\n\n<li>With special tests (calorics, vHIT), doctors correctly distinguished the two in 86% of cases<\/li>\n<\/ul>\n\n\n\n<p>Some people don\u2019t fit neatly into textbook definitions. When typical migraine signs are missing or attacks behave differently, specialists may speak of \u201csuspected VM\u201d\u2014a likely vestibular migraine that is not yet definitively confirmed.<\/p>\n\n\n\n<p><strong><strong>What does that mean for you?<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hearing problems or tinnitus point more toward M\u00e9ni\u00e8re\u2019s; headache and light sensitivity point more toward vestibular migraine.<\/li>\n\n\n\n<li>A good diagnosis usually requires more than just one test.<\/li>\n\n\n\n<li>A thorough assessment saves time, wrong treatments, and uncertainty.<\/li>\n<\/ul>\n\n\n\n<p><strong><strong>What Can You Do?<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ask your doctor about vestibular tests (e.g., vHIT or caloric testing).<\/li>\n\n\n\n<li>Even if tests are normal: a second opinion at a specialized vertigo center can bring clarity.<\/li>\n<\/ul>\n\n\n\n<p>\ud83c\udfaf <strong>Our IVRT\u00ae-certified dizziness and vestibular therapists<\/strong> support you with individualized balance training to regain confidence and well-being: <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-betroffene\/therapeutensuche\/\" data-type=\"page\" data-id=\"101\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT therapist search<\/a><\/strong><\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>F\u00fcr Fachpersonal: Vestibul\u00e4re Migr\u00e4ne (VM) und Morbus Meni\u00e8re (MD) sind h\u00e4ufige Ursachen wiederkehrender Schwindelattacken \u2013 und klinisch schwer zu unterscheiden. Die LMU-Studie zeigt, welche Merkmale am besten trennen \u2013 und wo die aktuellen Diagnosekriterien (ICVD) an ihre Grenzen sto\u00dfen. \ud83d\udd17Huppert D, Grill E, Becker-Bense S, Zwergal A, Strobl R. Diagnostic challenges in vestibular migraine-clinical differentiation [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":17467,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_jf_save_progress":"","iawp_total_views":272,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-17466","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-studien-evidenz"],"_links":{"self":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17466","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/comments?post=17466"}],"version-history":[{"count":1,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17466\/revisions"}],"predecessor-version":[{"id":17470,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17466\/revisions\/17470"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media\/17467"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media?parent=17466"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/categories?post=17466"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/tags?post=17466"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}