title: Intractable benign paroxysmal positional vertigo in patients with Meniere's disease.
abstract: OBJECTIVE
  To provide a detailed description of the coexistence of benign paroxysmal positional vertigo (BPPV) and Meniere's disease in individuals and to offer a possible mechanism that explains the findings in these patients.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Chart review.
  
  
  RESULTS
  Of 162 patients diagnosed with Meniere's disease between January 1998 and January 1999, 9 were found to have both "definite" Meniere's disease and "certain" BPPV. Meniere's symptoms preceded the onset of BPPV in all of our patients. Seven of the 9 patients were female. Except for one patient who experienced BPPV bilaterally, BPPV was limited to the same ear as the Meniere's disease. All patients presented with intractable BPPV that did not respond completely to otolith repositioning procedures. A detailed description of five patients is presented.
  
  
  CONCLUSIONS
  Our data, in conjunction with that of others, suggest that Meniere's disease may predispose patients to intractable BPPV. Hydropically induced damage to the maculae of the utricle and saccule or partial obstruction of the membranous labyrinth may be possible mechanisms that explain the coexistence of Meniere's disease and BPPV.
authors.affiliation: Division of Head and Neck Surgery, University of California-San Diego, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Gross
authors.forename: B D
authors.initials: BD
authors.lastname: Ress
authors.forename: E S
authors.initials: ES
authors.lastname: Viirre
authors.forename: J R
authors.initials: JR
authors.lastname: Nelson
authors.forename: J P
authors.initials: JP
authors.lastname: Harris
mesh_terms: D008267:Acoustic Maculae / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003937:Diagnosis, Differential; D007758:Ear, Inner / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D014717:Vertigo / Q000175:diagnosis* / Q000503:physiopathology