title: Bedside vestibular examination in patients with unilateral definite Ménière's disease.
abstract: CONCLUSIONS
  Although vestibular clinical examinations are quite variable in Ménière's disease (MD), when used in a grouped fashion they attach valuable information to the understanding of MD.
  
  
  OBJECTIVE
  Evaluation of unilateral MD vestibular bedside examination.
  
  
  METHODS
  This was a retrospective study of patients with definite unilateral MD at a tertiary care facility. Assessment of spontaneous nystagmus (SN), head-shaking nystagmus (HSN), head impulse test (HIT) and vibration-induced nystagmus (VIN) was carried out. Clinical manifestations and auditory and vestibular function were studied.
  
  
  RESULTS
  The study included 97 patients: 47 presented SN, 75 a positive HSN (biphasic in 14) and in 73 a VIN was observed. After excluding patients with biphasic HSN, a homogeneous response was observed in 43.4%: no nystagmus in 15.7%; nystagmus of similar direction in 27.8% (paretic, 14.5%; irritative, 13.3%). There were no significant differences in duration of the disease, functional level and vertigo index, although a trend towards a shorter time since last crisis was observed in patients with an irritative nystagmus. In 36.1% nystagmus was revealed with a consistent direction in at least one of the tests and in 20.5% it was non-coherent, something more frequently observed closer to the crisis. Independently only in VIN an irritative response was associated with a higher functional level and a shorter time from last attack.
authors.affiliation: Department of Otorhinolaryngology - Hospital de S. João, EPE, Porto, Portugal. pmsmarques@hotmail.com
authors.forename: Pedro Santos
authors.initials: PS
authors.lastname: Marques
authors.forename: Nicolas
authors.initials: N
authors.lastname: Perez-Fernandez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019416:Head Movements / Q000502:physiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D009760:Nystagmus, Physiologic / Q000502:physiology; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014724:Vestibular Function Tests / Q000379:methods*; D014722:Vestibule, Labyrinth / Q000503:physiopathology*; D055815:Young Adult