Equilibrium Research
Online ISSN : 1882-577X
Print ISSN : 0385-5716
ISSN-L : 0385-5716
Symposium: Mechanisms of the development of vertigo
Immunological Pathogenesis in Vertigo Attack
Shunichi Tomiyama
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2008 Volume 67 Issue 3 Pages 242-250

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Abstract
The hypothesis that certain types of vertigo develop through immunopathological mechanisms has been advocated for over 80 years. These days, many reports have been published that link immunity and vertigo with a variety of proposed immune-related etiologies, from autoimmunity to non-autoimmunity. Due to the inaccessibility of the labyrinth, it is difficult to take out obtain specimens of the inner ear tissue. In this paper, we present an animal model of Meniere's disease. Immune reaction following secondary antigen challenge in the endolymphatic sac of guinea pigs led to the development of endolymphatic hydrops, fluctuating hearing loss, precipitation of vertigo and suppression of the caloric response, similar to the symptomatology of Meniere's disease. These results strongly suggest that immune reaction in the endolymphatic sac is the likely cause of vertigo in Meniere's disesae. It is difficult to clinically distinguish between autoimmune inner ear disease and Meniere's disease, because of their clinical similarity. Western blotting examination of the serum for inner ear autoantibodies may aid in the differential diagnosis. Immunosuppressive drug treatment may be effective in patients with severe vertigo who show resistance to therapies used for Meniere's disease.
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© 2008 Japan Society for Equilibrium Research
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