Ruling out other diagnosis and when to rule in vestibular migraine


This newsletter series will explain how you can achieve vast time savings and yet gain more confidence in the diagnosis of the patient suffering from the most frequently diagnosed peripheral disorders. The goal of assessing the patient with vestibular symptoms is to determine if the disorder is unilateral or bilateral, what end organ is contributing to the disorder and the severity of the disorder, and assessing recovery after the onset of the disorder.

This is an exclusion diagnosis:

WF_V-migraine-300x112

Case History
Dizziness associated with migraineous symptoms, phonophobia (intolerance of sound), photophobia (intolerance of light), migraineous aura (scintillating scotoma, aphasia, etc.), motion sensitivity, tinnitus (high pitched). Migraineous headache present. Anxiety present.

Physical Exam & Spontaneous
Gaze upbeat nystagmus exists with and without fixation.

Impulse & Caloric
May or may not shows signs of abnormality

VEMP
cVEMP:
Within normal limits:

cVEMP-300x107 


oVEMP:

Within normal limits:

oVEMP-300x108 

What is the Diagnosis?

  1. Meniere’s Disease
  2. Superior Vestibular Neuritis
  3. Vestibular Migraine
  4. Inferior Vestibular Neuritis

Learn more
Diagnostic booklet – Describing the global trend in vestibular testing 
Analysis video

 

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