We report the case of a patient whit Meniere’s disease who was diagnosed as having a vestibular schwannoma (VS). The patient was a 40-year-old man who presented with vertigo. He gave a history of recurrent right-sided hearing loss, which led to a presumptive diagnosis of Meniere’s disease on the right side. Magnetic resonance imaging (MRI) performed to screen for intracranial lesions revealed a right VS. The patient was therefore referred to our hospital for vertigo evaluation and follow-up.
At the initial visit, no overt abnormalities were observed, and the vertigo was initially attributed to the VS. However, the absence of significant findings on neuro-otological examinations raised questions about whether the symptoms were truly caused by the tumor. We then performed the cVEMP (cervical Vestibular Evoked Myogenic Potential) tuning property test, which yielded positive results in both ears, suggesting the presence of bilateral endolymphatic hydrops (EH). Gadolinium-enhanced inner ear MRI further confirmed the diagnosis of bilateral EH.
Given the presence of EH in the contralateral ear, we concluded that this was a case of right Meniere’s disease with subclinical EH in the left ear, and that the right VS was an incidentally coexistent asymptomatic lesion. The patient’s symptoms have since remained stable under treatment with isosorbide.
