Background: Vestibular
Meniere's disease (American Academy of Ophthalmology and Otolaryngology, 1972) also known as possible
Meniere's disease (American Academy of Otolaryngology Head and Neck Surgery, 1995) or vestibular type of atypical
Meniere's disease (V-AMD) (Japan Society for Equilibrium Research, 2017) is characterized by an episodic
vertigo without
hearing loss. Though named as
Meniere's disease (MD), this entity may not be caused solely by
endolymphatic hydrops (EH). Objective: To estimate the role of EH in vestibular
Meniere's disease in comparison with definite
Meniere's disease. Methods: Thirty patients with unilateral definite MD and 16 patients with vestibular
Meniere's disease were included. Those who met the criteria for definite or probable vestibular
migraine were excluded. All patients underwent vestibular assessments including inner ear MRI 4 h after intravenous
gadolinium injection, bithermal caloric testing, directional preponderance of vestibulo-ocular reflex in rotatory chair test, cervical- and ocular-vestibular evoked myogenic potential, stepping test,
dizziness handicap inventory (DHI), and hospital anxiety and depression scale (
HADS). All above tests and frequency/duration of
vertigo spells were compared between vestibular
Meniere's disease and MD. Results: Even in unilateral MD, cochlear and vestibular
endolymphatic hydrops (c-, v-EH) were demonstrated not only in the affected side but also in the healthy side in more than half of patients. Positive rate of v-EH in vestibular
Meniere's disease (68.8%) was as high as that of MD (80%). In vestibular
Meniere's disease, the number of bilateral EH was higher in the vestibule (56.3%) than that in the cochlea (25.0%). There were no differences in vestibular tests and DHI between vestibular
Meniere's disease and MD; however, the frequency of
vertigo spells was lower in vestibular
Meniere's disease (p = 0.001). The total
HADS score in the MD group was significantly higher than that in the vestibular
Meniere's disease group. Conclusions: MD is a systemic disease with bilateral involvement of inner ears. V-EH is a major pathophysiology of vestibular
Meniere's disease, which would precede c-EH in the development of vestibular
Meniere's disease, a milder subtype of MD. MRI is useful for differentiating MD from other
vertigo attacks caused by different pathologies in bringing EH into evidence.