ObjectiveTo explore the clinical value of vestibular autorotation test (VAT) and caloric test in the differential diagnosis of early Meniere’s disease (MD) and vestibular migraine (VM).MethodsVAT and caloric test were applied to 24 patients suffering from MD in the nonacute phase (MD group) and 22 cases with VM (VM group)．All patients in both groups undertook VAT followed by caloric test. The evaluated parameters in VAT included horizontal gain/phase, vertical gain/phase and asymmetry. Any abnormality of the abovementioned five parameters was defined as abnormal vestibular function. In caloric test, canal paresis (CP) and the maximum slow phase velocity (SPVmax) were recorded and calculated. CP≥25% was defined as positive. The result differences between the two groups were analyzed statistically.ResultsVAT results revealed abnormal vestibular function in 16 cases (66.7%) in the MD group and 12 (54.5%) in the VM group. The difference of detection rate of abnormal vestibular function between both groups was statistical insignificance (P>0.05). In the MD group, gain was found to be abnormal in 10 cases including one with increased gain and 8 with decreased gain, as well as one with partly increased and partly decreased gains in horizontal testing. Phase delay was detected in 12 cases, and abnormal asymmetry was observed in 5. In the VM group, gain was found to be abnormal in 7 cases including 6 with increased gain and 1 with decreased gain, and phase delay was observed in 10 cases. The difference of detection rate of abnormal gain between the two groups was statistically significant (P<0.05). Caloric test was abnormal in 14 cases (58.3%) in the MD group and 4 (18.2%) in the VM group. The average SPVmax was 10.5±9.5 °/S in the MD group and 34.7±17.9 °/S in the VM group, respectively. The positive rate of CP between the two groups were significantly different (P<0.05)，and the SPVmax in the MD groups was significantly lower than that in the VM group (P<0.05).ConclusionVAT is mainly characterized by decreased 4-6 Hz gain and 4-6 Hz lagged phases in patients with MD, as well as increased 2-4 Hz gain and 4-6 Hz lagged phases in patients with VM. Caloric responses are usually diminished in patients with MD, whereas hypractive or normal in patients with MD. The two tests are complementary in vestibular frequency, which may facilitate the differential diagnosis of early MD from VM.