Nystagmus at the Onset of Vertiginous Attack in Ménièreʼs Disease

OBJECTIVE:To clarify the direction and characteristics of nystagmus at the onset of a vertiginous attack in Ménièreʼs disease. PATIENTS:Two patients with Ménièreʼs disease, whose nystagmus at the onset of a vertiginous attack was recorded using electronystagmography. INTERVENTIONS:Diagnostic. MAIN OUTCOME MEASURES:Electronystagmographic recordings of nystagmus. RESULTS:In both patients, nystagmus was directed toward the affected side over the entire course of the vertiginous attack. One patient experienced a severe sensation of vertigo and exhibited strong nystagmus from the onset of the attack. The other patient reported a mild sensation of vertigo, which was accompanied by intermittent nystagmus. CONCLUSIONS:Vertiginous attacks in Ménièreʼs disease are accompanied by irritative nystagmus. The intensity and characteristics (e.g., continuous or intermittent expression) of the nystagmus may be associated with pathophysiological severity.