Recurrent attacks of vertigo without cochlear symptoms are called vestibular Meniere's disease (VMD), but the etiology has not yet been defined. VMD was diagnosed in 30 patients in Gifu University Hospital between 1987 and 1993. We reviewed the course of vertigo including cochlear symptoms. Hearing tests, electrocochleography and the furosemide VOR test were performed to investigate the etiology.
1. The patients were divided into four groups according to the course of vertigo. Less frequent attacks were observed in eight patients, while seven patients had periodic attacks. Fourteen patients had frequent attacks with in a few years. One patient had sporadic attacks but the frequency had increased recently. Fourteen of 30 patients had repeated attacks over a long period (6-40 years) without cochlear symptoms.
2. Electrocochleography and the furosemide VOR test were performed on 16 patients with VMD. Seven patients were positive for furosemide VOR test and negative for electrocochleography. There were four patients who were positive for both tests, while two patients were negative for the furosemide VOR test but positive for electrococ-hleography. Five of seven patients who had recurrent attacks over a long period without cochlear symptoms were positive for either test. These findings suggested that the etiology was endolymphatic hydrops.
3. In two patients, fluctuating hearing loss was noted on hearing tests. Therefore, they were diagnosed with Meniere's disease.
4. In one patients, tumor of the fourth ventricle was detected after 15 years.
