2025 Volume 118 Issue 11 Pages 791-803
In this study, I selected cases with the first episode of definite Ménière’s disease (MD) among vertigo patients who visited my clinic over the past three years and retrospectively reviewed their age at the first visit, gender, affected side, and the transition rate to persistent postural-perceptual dizziness (PPPD).
Eligible subjects were new first-ever cases of MD who visited my clinic during the three-year period between June 1, 2020, and May 31, 2023, who met the diagnostic criteria for MD established by the Japan Society for Equilibrium Research, revised in 2017.
There were a total of 111 cases, including 27 male and 84 female patients. The male-to-female ratio was 1:3.1, indicating that most of the patients were female. The mean age ± standard deviation was 45.4 ± 16.2 years.
The period from the initial episode until the initial consultation was 3 days in 49 cases, under 7 days in 29 cases, under 14 days in 13 cases, under 21 days in 5 cases, under 28 days in 2 cases, and 29 days or longer in 13 cases, indicating that 70.3% of the patients sought diagnosis within 7 days of symptom onset.
In regard to the affected side, the right side was affected in 52 cases and the left side in 56 cases. There were only 3 cases with bilateral involvement.
The most common subjective symptom was aural fullness in 95 cases (85.6%), followed by vertigo in 68 cases (61.2%), hearing loss in 76 cases (68.5%), tinnitus in 59 cases (53.2%), hyperacusis in 28 cases (25.2%), and autophony in 22 cases (19.8%).
In regard to the underlying diseases, there were 16 cases with hypertension, 10 cases with hyperlipidemia, 9 cases with heart disease, including arrhythmia, 6 cases with diabetes mellitus, and 23 cases with insomnia. Four patients had a current or past history of psychiatric disorder. There were 37 cases with concurrent migraine and 39 cases with concurrent tension headache.
As for the time to remission, remission concurrent within 3 months in 20 cases, and took 3 months or longer in 91 cases. A total of 19 patients decided to stop coming to the clinic, and their status is unknown.
In this study, there were 4 cases of MD, and 1 case MD with vestibular migraine (VM) that transitioned to PPPD.
The transition rate only for cases that transitioned from MD to PPPD was 3.6％, and that for cases that transitioned from MD with VM to PPPD was 4.5％. After excluding cases whose status was unknown, the transition rate only for cases that transitioned from MD to PPPD was 4.3％, and that for cases including those that transitioned from MD with VM to PPPD was 5.4％.
As compared to the transition rate to PPPD of cases with definite benign paroxysmal positional vertigo examined previously, the transition rate to PPPD of cases with definite MD was higher.
