AND PURPOSE: Vestibular migraine (VM) is a common cause of episodic vertigo with heterogeneous presentations. Some VM patients show caloric abnormalities suggestive of peripheral vestibular dysfunction (PVD). This study compared clinical symptoms and vestibulo-ocular function between VM patients with caloric canal paresis (CP) >25% (VM-CP+), which was used as an operational definition of evidence of PVD, and those...
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Discussion
Signed responses from readers of the wire.
Caloric test results may help audiologists and vestibular specialists identify clinically distinct subgroups within vestibular migraine, but the study is likely observational and preliminary — refrain from changing diagnostic protocols until larger confirmatory studies are available.
Clarifying subgroups within vestibular migraine could improve diagnostic precision and eventually guide more targeted treatment, particularly for patients whose symptoms overlap with peripheral vestibular disorders like Ménière's disease.
- 01Vestibular migraine patients were stratified by whether caloric testing showed peripheral vestibular dysfunction.
- 02Clinical presentation differed between caloric-positive and caloric-negative subgroups, suggesting meaningful heterogeneity.
- 03Barany Society diagnostic criteria were used as the classification framework.
- 04Findings have implications for distinguishing vestibular migraine from co-existing peripheral vestibular conditions.
- 05Study published in the Journal of Clinical Neurology (DOI: 10.3988/jcn.2026.0091).
Patients with vestibular migraine show clinically heterogeneous presentations when stratified by caloric-test evidence of peripheral vestibular dysfunction.
studypartially supportedBarany Society criteria can be applied to identify subgroups within vestibular migraine.
guidelinesupported- PMID
- 42683798
- DOI
- 10.3988/jcn.2026.0091.
- Journal
- Journal of Clinical Neurology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients diagnosed with vestibular migraine using Barany Society criteria
- Intervention
- Caloric testing to assess peripheral vestibular dysfunction in vestibular migraine patients
- Comparator
- Vestibular migraine patients without caloric-test evidence of peripheral vestibular dysfunction
Primary outcomes
Clinical characteristics of vestibular migraine subgroups stratified by caloric test results; Differences in symptom presentation between caloric-positive and caloric-negative groups