Vertigo in vestibular Ménière's disease is similar to that in Ménière's disease, but in the former there are no cochlear symptoms.
A 58-year-old woman visited Gifu University Hospital on August 31, 1987, complaining of recurrent attacks of vertigo. She had no cochlear symptoms. Caloric tests indicated left canal paresis, but no abnormalities were detected on CT scan. We diagnosed vestibular Ménière's disease. She later complained of positional vertigo with severe nausea and visited our hospital again on February 15, 1990.
Neurological findings : Lateral gaze directional nystagmus and down beat head shaking nystagmus were seen. In voluntary OKN, smooth pursuit was abnormal but saccadic eye movement was not. We speculated that disorders of eye movements were caused by a lesion of the flocculus or its connection to the vestibular nuclei.
MRI findings : MRI showed a tumor of the fourth ventricle, compressing the right cerebellar peduncle.
Neurological findings corresponded with MRI findings.
We conclude that the vertigo was due to vertebrobasilar insufficiency or endolymphatic hydrops caused by disturbance of CSF flow.
