Vestibular Meniere's Disease and Endolymphatic Hydrops

Vestibular Meniere's disease (VMD) is characterized by episodic vertigo without hearing loss or tinnitus. A comparative study was made in 44 patients with VMD in relation to duration of vertigo attacks, electrocochleographic findings and therapeutic effect of isosorbide (oral hyperosmotic agent). Isosorbide was effective in preventing attacks that persisted for more than 20 min in patients with a dominant-SP in electrocochleography. Six of these patiens subsequently developed typical Meniere's disease. These findings suggest that the pathogenesis of VMD with prolonged vertigo attacks is endolymphatic hydrops. However, isosorbide failed to prevent attacks that persisted for less than 20 min. It seems that the pathogenesis of VMD with short vertigo attacks is not endolymphatic hydrops.