Recovery nystagmus in ménière's disease

Spontaneous nystagmus occurs during a Meniere's attack although the literature indicates that the direction can be variable. Previous observations made during the acute and recovery stages of a Meniere's attack suggested that the direction of the spontaneous nystagmus was consistent with the primary-secondary sequence of nystagmus that occurs with relatively prolonged stimulation of the normal vestibulo-oculomotor system. To evaluate this nystagmus pattern further, spontaneous nystagmus was monitored in eight patients using DC electronystagmography during an acute Meniere's attack. All showed an initial contralateral nystagmus during the acute phase of the attack with reversal to an ipsilateral (or recovery) nystagmus, as the acute symptoms subsided. Such a pattern of nystagmus occurring over a few hours is a helpful diagnostic aid, and when surgery is being considered, it provides objective evidence of the ear with active disease.