Extended phenotype and clinical subgroups in unilateral Meniere disease: A cross‐sectional study with cluster analysis

Objectives To define clinical subgroups by cluster analysis in patients with unilateral Meniere disease ( MD ) and to compare them with the clinical subgroups found in bilateral MD . Design A cross‐sectional study with a two‐step cluster analysis. Settings A tertiary referral multicenter study. Participants Nine hundred and eighty‐eight adult patients with unilateral MD . Main outcome measures: best predictors to define clinical subgroups with potential different aetiologies. Results We established five clusters in unilateral MD . Group 1 is the most frequently found, includes 53% of patients, and it is defined as the sporadic, classic MD without migraine and without autoimmune disorder ( AD ). Group 2 is found in 8% of patients, and it is defined by hearing loss, which antedates the vertigo episodes by months or years (delayed MD ), without migraine or AD in most of cases. Group 3 involves 13% of patients, and it is considered familial MD , while group 4, which includes 15% of patients, is linked to the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by a comorbid AD . We found significant differences in the distribution of AD in clusters 3, 4 and 5 between patients with uni‐ and bilateral MD . Conclusions Cluster analysis defines clinical subgroups in MD , and it extends the phenotype beyond audiovestibular symptoms. This classification will help to improve the phenotyping in MD and facilitate the selection of patients for randomised clinical trials.