Nystagmus during vertigo attacks in Menière’s disease may vary in direction, being predominantly horizontal but sometimes vertical, and was documented using mobile phone recordings, according to a recent study.
Researchers conducted a retrospective study examining the characteristics of nystagmus during vertigo attacks in patients with Menière’s disease and assessed the feasibility of self-video recording of eye movements using a mobile phone. In the study, published in the Journal of Clinical Medicine, the researchers analyzed data from 17 patients (mean age, 61 years, range = 29–85 years, 11 men, 6 women) diagnosed with definite Menière’s disease based on Barany Society criteria. They aimed to determine the diagnostic and therapeutic implications of nystagmus characteristics and the utility of mobile phone video recordings in clinical assessment.
Among the17 patients, 12 had Menière’s disease and 5 had delayed endolymphatic hydrops. Nystagmus was recorded using videonystagmoscopy by a physician in 8 patients, a mobile phone in 8 patients, and both methods in 1 patient. Horizontal nystagmus was observed in 14 patients, with 7 exhibiting the irritative type (beating toward the affected ear), 5 showing the deficit type (beating contralaterally), and 2 experiencing a directional change from deficit to irritative. Vertical nystagmus was recorded in 3 patients, with 2 demonstrating down-beating and one presenting up-beating nystagmus. Two of these patients exhibited a transition from vertical to horizontal nystagmus during the same episode.
Led by Valéria Ionescu, of Département d’ORL at the Centre Hospitalier Universitaire de Saint Etienne in France, the researchers concluded that the direction of nystagmus was highly variable and did not provide a reliable indicator for identifying the affected ear, reinforcing that hearing dysfunction remains the primary diagnostic marker for Menière’s disease. Mobile phone recordings successfully documented vertigo episodes and provided objective evidence of nystagmus; however, the study acknowledged that ocular fixation may dampen nystagmus intensity, potentially limiting diagnostic accuracy. While the study primarily examined nystagmus patterns, it also noted that 9 patients underwent chemical labyrinthectomy with intratympanic gentamicin injections, with vertigo controlled in 8 patients over a mean follow-up of 5.6 years. One patient with a history of middle ear surgery did not respond to gentamicin and later underwent surgical labyrinthectomy.
The study found that nystagmus direction varied widely and was not a reliable indicator of the affected ear, confirming that hearing dysfunction remains the key diagnostic marker for Menière’s disease.
Full disclosures can be found in the published study.