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. 2022 Mar 2:13:817812.
doi: 10.3389/fneur.2022.817812. eCollection 2022.

Benign Recurrent Vertigo: The Course of Vertigo Attacks Compared to Patients With Menière's Disease and Vestibular Migraine

Roeland B van Leeuwen  1 , Carla Colijn  1 , Babette F van Esch  2 , Tjard R Schermer  1   3
Affiliations

Benign Recurrent Vertigo: The Course of Vertigo Attacks Compared to Patients With Menière's Disease and Vestibular Migraine

Roeland B van Leeuwen et al. Front Neurol. .

Abstract

Objective: To explore the course of vertigo attacks in patients with benign recurrent vertigo (BRV) as compared to patients with Menière's disease (MD) and vestibular migraine (VM).

Study design: Prospective cohort study.

Setting: Tertiary referral center.

Patients: Adult patients who visited the Apeldoorn Dizziness Center between January 2015 and November 2016 and who were diagnosed with BRV, VM or MD. During 3 years participants were contacted every 6 months by telephone to complete a study-specific questionnaire.

Main outcome measures: Vertigo attack frequency, use of medication, and Hospital Anxiety and Depression Scale (HADS).

Results: The study population (n = 121) consisted of 44 patients with BRV, 34 with VM, and 43 with MD. For the total follow-up period no statistically significant differences between the three diagnosis groups were observed for being attack-free in the past 6 months: OR = 0.86 (95% CI 0.34-2.17; p = 0.745) for VM and OR = 1.06 (95% CI 0.44-2.51; p = 0.902) for MD, compared to BRV. Overall, 19 patients (43.2%) with BRV, 13 (38.2%) with VM, and 35 (81.0%) with MD used medication to prevent vertigo attacks at any point during their 3-year follow-up. Throughout the observation period patients with MD showed an average of 3.37 points (95% CI 0.68-6.07; p = 0.014) higher HADS scores relative to patients with BRV.

Conclusion: The course of vertigo attacks was rather favorable in the three groups, as 67-70% of the patients were free of vertigo attacks after 3 years of follow-up. The course of disease in patients with BRV was not distinctive from patients with MD and VM. We assume that BRV is a mild or incomplete variant of VM and MD, rather than a separate disease entity with distinct pathognomonic features.

Keywords: Menière's disease; attacks; benign recurrent vertigo; medication; mental health limitations; prognosis; vestibular migraine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Inclusion and follow-up of the study population. BRV, benign recurrent vertigo; VD, vestibular migraine; MD, Menière's disease.
Figure 2
Figure 2
Use of vertigo medication during the 3-year follow-up period in the three diagnosis groups*. *Medication use in the past 6 months was tested at 36 months, the difference between the groups being statistically significant (Chi-square test, p < 0.001).
Figure 3
Figure 3
Proportions of patients without vertigo attacks during the past 6 months as reported by the patients in the three diagnosis groups at the consecutive follow-up visits. Differences between the groups were statistically tested using generalized estimating equations models. Overall, there were no statistically significant differences between the groups for the follow-up period as a whole.
Figure 4
Figure 4
Course of HADS scores during the 3-year follow-up period in patients with benign recurrent vertigo, vestibular migraine and Menière's disease. None of the follow-up contact * diagnosis group interaction terms showed statistically significant differences in HADS scores. HADS, Hospital Anxiety and Depression Scales.
See this image and copyright information in PMC

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