OBJECTIVE: To evaluate the association between migraine, episodic vertigo, and 
Ménière's disease in families.
STUDY DESIGN: Clinical report.
SETTING: University Neurotology Clinic.
PATIENTS: Index patients identified with Ménière's disease and migraine and 
their family members.
INTERVENTION: Structured interview to assess a diagnosis of migraine, episodic 
vertigo, and Ménière's disease in 6 families. Genotyping was performed on 3 sets 
of twins to analyze monozygosity or dizygosity.
MAIN OUTCOME MEASURES: Clinical history of migraine, episodic vertigo, and 
Ménière's disease.
RESULTS: Six index patients and 57 family members were interviewed either by a 
senior neurologist in person or over the phone by a trained study coordinator. 
An additional 6 family members completed questionnaires by mail. All 6 index 
patients had Ménière's disease and migraine. Twenty-six (41%) of the 63 
relatives met International Classification of Headache Disorders II criteria for 
migraine headaches. Thirteen (50%) of these 26 experienced migraine with aura. 
Three others experienced typical aura without headache. Seventeen (27%) of 63 
family members experienced recurrent spells of spontaneous episodic vertigo. 
There was one twin pair in each of 3 families; 2 pairs were monozygotic and one 
was dizygotic. In each twin pair, one twin had migraine and Ménière's disease, 
whereas the other experienced migraine and episodic vertigo without auditory 
symptoms.
CONCLUSION: The frequent association of episodic vertigo, migraine, and 
Ménière's disease in closely related individuals, including identical twins 
supports the heritability of a migraine-Ménière's syndrome, with variable 
expression of the individual features of hearing loss, episodic vertigo, and 
migraine headaches.