A groundbreaking study published on August 13 in *Frontiers in Neurology* has unveiled a significant method for differentiating between Meniere disease (MD) and vestibular migraine (VM), two conditions that can often confuse both patients and healthcare professionals. The research suggests that the contrast between caloric test results and video head impulse test outcomes may hold the key to accurate diagnosis.

Led by Vergil Mavrodiev and his team at LMU University Hospital in Munich, the study analyzed data from 2,101 patients, focusing primarily on a group of 1,100 participants diagnosed with MD and VM—57% diagnosed with Meniere disease and 43% with vestibular migraine. The remaining 1,001 patients suffered from various other peripheral, central, or functional vestibular disorders.

The findings showed that the correlation between abnormal caloric testing and a normal video head impulse test yielded promising results for differentiating MD from VM. Specifically, the study reported a specificity of 83.5%, sensitivity of 58.9%, positive predictive value (PPV) of 82.6%, and negative predictive value (NPV) of 60.5% when distinguishing MD from VM. Moreover, when MD was compared against all other vestibular disorders, the specificity remained at 83.5%, while sensitivity and PPV adjusted to 58.9% and 60.3%, respectively. The NPV for this comparison was a notable 82.7%.

The authors underscored the clinical importance of these findings, noting that the high specificity (83.5%) for Meniere disease indicates that the discrepancy can serve as a reliable rule-out test, especially for patients who do not exhibit the typical early-stage symptoms of MD.

This research carries the potential for a transformative impact on how healthcare providers approach diagnosis in patients presenting with vestibular symptoms. As MD and VM share overlapping symptoms, this novel diagnostic approach could lead to better-targeted treatments and improved outcomes for affected individuals.

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