Vibration-Induced Nystagmus in Meniere's Disease

Jeong, Woo Jin; Choi, Kwang Dong; Kim, Ji Soo; Koo, Ja Won

Abstract

BACKGROUND AND OBJECTIVES: Clinical presentation of Meniere's disease is dynamic. Nystagmus changes phase to phase, which is attributed to central compensation and recovery process in the peripheral vestibular system. Vibration-induced nystagmus (VIN) has been shown to reflect side difference of peripheral vestibular excitability. Aim of this study was to analyze the characteristics of VIN between attacks in Meniere's disease.
SUBJECTS AND METHOD
48 patients with unilateral Meniere's disease (definite criteria) were included. Auditory and vestibular function tests including caloric test, post-head shaking nystagmus (pHSN) and VIN were evaluated during symptom free period. Vibratory stimuli (100 Hz) was applied to both mastoids and forehead, and direction of horizontal nystagmus was recorded using video eye movement recording system or video nystagmography system, which was then compared with pHSN and caloric test results.
RESULTS
Thirty-one patients (65%) showed VIN in at least one area. VIN to ipsilesional side was noted in 13 cases, and to contralesional side in 18. In patients with canal paresis (CP) over 30% (N=27), 10 beat to ipsilesional side, 6 to contralesional side, and 11 showed no VIN. In patients with CP of less than 30% (N-21), 3 beat to ipsilesional side, 12 to contralesional side, and 6 showed no VIN (p < 0.05). Thirty-six patients (75%) showed pHSN, and 28 patients of them (78%) showed contralesional nystagmus.
CONCLUSION
Presence of ipsilesional VIN was significantly higher in Meniere's disease group with low CP, which suggests that the capacity of functional recovery by vestibular end organ may be higher in early Meniere's disease.