Vosbeek EGM et al. published in 2025, in *Otology & Neurotology*, the first systematic review with a meta-analysis to assess the role of caloric tests and vHIT in distinguishing between Ménière’s disease (MD) and vestibular migraine (VM). The study is notable for its robust methodology and included 21 studies and 3,096 patients.
The authors demonstrated that canalicular paresis on caloric tests is significantly more common in DM (OR=7.0), and is the vestibular marker with the highest discriminatory value. Abnormal vHIT results (OR = 3.38) and the presence of corrective saccades (OR = 3.52) were also more common in DM. In clinical practice, these results suggest that evidence of peripheral vestibular dysfunction may support the diagnosis of MD in cases of recurrent vertigo with an ambiguous clinical presentation.
