Vestibulo-ocular reflex characteristics in patients with unilateral Ménière's disease.

Details

Serval ID
serval:BIB_AB7A8004FD4C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Vestibulo-ocular reflex characteristics in patients with unilateral Ménière's disease.
Journal
Otology and Neurotology
Author(s)
Maire R., van Melle G.
ISSN
1537-4505[electronic]
Publication state
Published
Issued date
2008
Volume
29
Number
5
Pages
693-698
Language
english
Abstract
OBJECTIVE: The pathophysiologic concept of Ménière's disease assumes that endolymphatic hydrops is the cause of the symptoms via increased pressure in the endolymphatic space and/or ionic disorder due to ruptured membrane. The goal of this study was to assess whether the vestibulo-ocular reflex (VOR) properties in patients with Ménière's disease were consistent with the classical theory. MATERIAL AND METHODS: We studied 34 patients (19 women, 15 men) presenting with unilateral Ménière's disease divided into 2 groups according to the duration of the disease: 18 were in the early stage (< 12 mo), and 16 were in the late stage (> or = 12 mo). Nineteen patients were examined during an attack. Eight of them and the 15 other patients were tested during the interval between attacks. Their characteristics were compared with those of a group of 22 normal subjects. The VOR function was evaluated via standard caloric and impulse rotatory tests (velocity step). A mathematic model of vestibular function was used to characterize the VOR response to rotational stimulation. Dynamic VOR parameters (sensitivity coefficient, time constant, gain, and asymmetries between the 2 directions of rotation) were statistically compared between the 2 groups of patients during and between attacks and between the patients and controls. RESULTS: All dynamic VOR parameters showed no statistically significant difference both with normal controls and among the patients during and between attacks (p > 0.05) except for gain asymmetry (p < or = 0.008). During attacks, patients with early Ménière's disease displayed a higher gain in rotation toward the affected ear, the opposite being observed in patients with late disease. Caloric test revealed a moderate canal paresis on the affected side during the crisis and a slight asymmetry between attacks. CONCLUSION: During attacks in patients with early Ménière's disease, the VOR gain toward the affected side is higher than that toward the intact side, supporting the fact that that the sensitivity of the cupuloendolymphatic system on the affected ear is increased. This observation is in agreement with a mechanical pressure effect of hydrops on the vestibular organs.
Keywords
Adult, Aged, Caloric Tests, Female, Humans, Male, Meniere Disease/diagnosis, Meniere Disease/physiopathology, Middle Aged, Reflex, Vestibulo-Ocular/physiology, Rotation
Pubmed
Web of science
Create date
03/10/2009 11:08
Last modification date
20/08/2019 15:15
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