Otolith dysfunction during vertiginous attacks in Ménière's disease

Area of Science:

• Otolaryngology
• Neuroscience
• Vestibular System

Background:

• Ménière's disease (MD) attacks involve various vertigo types, including rotatory vertigo, dizziness, and drop attacks.
• Dizziness without spontaneous nystagmus may indicate otolith dysfunction.
• Delayed endolymphatic hydrops is another condition affecting vestibular function.

Purpose of the Study:

• To investigate otolith dysfunction during vertiginous attacks in Ménière's disease (MD).
• To evaluate otolith dysfunction in patients with delayed endolymphatic hydrops.
• To assess the role of otolith dysfunction in atypical MD attacks.

Main Methods:

• Conducted daily vestibular function tests for 11 patients (9 MD, 2 delayed endolymphatic hydrops) during vertigo attacks.
• Assessed otolith function using static ocular torsion (OT) in an upright position.
• Defined otolith dysfunction by abnormal OT changes without spontaneous nystagmus or with unchanged spontaneous nystagmus.

Main Results:

• Four patients exhibited abnormal static ocular torsion (OT) changes during vertiginous attacks.
• These abnormal OT changes occurred without spontaneous nystagmus or without a change in existing spontaneous nystagmus.
• Otolith dysfunction was identified in a subset of patients experiencing MD vertigo attacks.

Conclusions:

• Otolith dysfunction is present during vertiginous attacks in Ménière's disease patients.
• Atypical MD attacks, particularly those with ataxia and no spontaneous nystagmus, are likely caused by otolith dysfunction.
• This finding aids in understanding the pathophysiology of varied MD presentations.