Objective: To clarify the direction and characteristics of nystagmus at the onset of a vertiginous attack in Ménière's disease.
Patients: Two patients with Ménière's disease, whose nystagmus at the onset of a vertiginous attack was recorded using electronystagmography.
Interventions: Diagnostic.
Main outcome measures: Electronystagmographic recordings of nystagmus.
Results: In both patients, nystagmus was directed toward the affected side over the entire course of the vertiginous attack. One patient experienced a severe sensation of vertigo and exhibited strong nystagmus from the onset of the attack. The other patient reported a mild sensation of vertigo, which was accompanied by intermittent nystagmus.
Conclusions: Vertiginous attacks in Ménière's disease are accompanied by irritative nystagmus. The intensity and characteristics (e.g., continuous or intermittent expression) of the nystagmus may be associated with pathophysiological severity.