Caloric-vHIT Dissociation in Vestibular Migraine: An Observational, Retrospective Case Series Study
Abstract
Background: Caloric–vHIT (CalHiT) dissociation has been considered highly characteristic of Ménière’s disease (MD), but its occurrence in vestibular migraine (VM) remains incompletely characterized. Objective: The primary aim was to characterize, through detailed longitudinal analysis, the clinical and mechanistic heterogeneity underlying caloric-vHIT dissociation in seven patients with definite VM in a retrospective cohort. Study design: Observational, retrospective case series. Methods: From a standardized vestibular cohort of 100 consecutive patients with definite MD or VM evaluated between 2015 and 2018, seven patients with definite VM who exhibited caloric-vHIT dissociation were identified and followed up for approximately seven years. The frequency of dissociation patterns within the source cohort was recorded to contextualize case selection, and each case was characterized descriptively as follows: Patterns were classified as CalHiT-0 (CP < 22%, vHIT ≥ 0.80), CalHiT-A (CP ≥ 22%, vHIT ≥ 0.80), CalHiT-B (CP < 22%, vHIT < 0.80), and CalHiT-C (CP ≥ 22%, vHIT < 0.80). Results: At the cohort level, A-pattern dissociation occurred in 17.5% of patients with VM (7/40) and 56.7% of patients with MD (34/60), while B-pattern dissociation was rare (MD: 2/60, 3.3%; VM: 1/40, 2.5%). One patient with CalHiT-A VM was lost to follow-up and excluded from the longitudinal analysis. At the case level, the seven cases (six CalHiT-A and one CalHiT-B) suggested mechanistic heterogeneity,…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 100 participants or records.
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