[Initial symptoms in Meniere's disease]

Menière's disease appears with the classic triad of symptoms in about 1/3 of cases so that, on the whole, diagnosis is delayed until full symptomatology develops. Spontaneous reversibility and effective control, if any, of the disease mechanism are limited to the beginning phases and thus it seems appropriate focus attention on the earliest symptoms. Unfortunately, the pre-diagnosis period is poorly known and, for this reason, we decided to investigate it in our series. The purposes of this research were: 1) to estimate the prevalence of isolated symptoms in subjects successively found to be menieric; 2) to make a clinical outline of the pre-diagnosis period; 3) to investigate the relationship between the pre-diagnosis period and the post-diagnosis disease course. From a group of 216 Menière's patients (diagnosed according to the 1985 AAOO criteria), 170 were selected on the basis of availability of audiometric and clinical data pertaining to the pre- and post-diagnosis disease course. Isolated symptoms in the pre-diagnosis period were found in 107/170 subjects (63%). The nature of the symptoms was cochlear (71.9%), vestibular (22.4%) and mixed (5.6%). In the largest group of patients (41 cases), the pre-diagnosis period lasted from 2 to 5 years. This period was shorter in the cases with mixed symptoms in comparison with patients suffering from either cochlear or vestibular symptoms. Between the 2nd and 5th year following diagnosis, hearing was seen to deteriorate more significantly in patients with a history of isolated cochlear symptoms. Furthermore, patients whose first disturbances were of cochlear origin suffer significantly shorter vertigo attacks.(ABSTRACT TRUNCATED AT 250 WORDS)