Evolution of symptoms in Ménière's disease

BACKGROUND: Ménière's disease (MD) is a complex illness characterized by the typical association of acute onset of vertigo lasting less than 12-24 hours and low-frequency sensorineural fluctuating hearing loss. In our cohort of patients, MD manifested immediately as its definite form in about 35% of cases whereas in the remaining 75% of cases the pathology started as a monosymptomatic form. METHODS: In order to determine the temporal relationship among these two forms, we evaluated the clinical history on 283 patients affected by definite MD. RESULTS: The very first symptom of MD resulted more frequently the hearing loss. The average time delay between the onset of the first and the second symptom resulted within one year. The risk of onset of the definite form after the first symptom was about 80% within 5 years. The transition from the monosymptomatic form the definite form was quicker in case of vertigo happened as the first symptom. CONCLUSIONS: In conclusion the most frequent layout of onset of MD is a unilateral low-frequency sensorineural fluctuating hearing loss fol lowed by the appearance of vertigo within 5 years. According to the MD guidelines proposed in 1995, all patients referring such kind of hearing loss should be treated as MD, in order to prevent the subsequent occurrence of vertigo.