Clinical testing of the statolith system in patients with Menière's disease

The statolith ocular reflex induced by whole body roll was assessed in 10 patients with Meniere's disease who had undergone a standard vestibular test battery. Normal eye torsion was noted in 4 patients despite the presence of severe symptoms, and a caloric hyporeflexia in one patient. Eye torsion was diminished in one direction of body roll in 4 patients and in both directions of body roll in 2 patients. An abnormal asymmetry of eye torsion (> 16%) was found in the case of body roll towards the normal ear irrespective of whether a caloric asymmetry was found. An abnormal asymmetry of the statolith ocular reflex seems to indicate the side with the functional hearing loss. The results suggest that Meniere's disease might involve pathology of the statolith system. However, the absence of abnormal eye torsion does not imply normal vestibular function.