Abstract:
:In patients with Ménière's disease (MD), caloric testing can show, depending on the stage and activity of the disease, a variety of results. Between attacks, many, or perhaps even most, patients with unilateral early or mild MD have normal caloric tests; late MD can show abnormalities ranging from mild to severe unilateral canal paresis with or without directional preponderance. The explanation of canal paresis in MD is not clear. The most obvious explanation, severe loss of lateral canal hair cells, is not likely to be correct because hair cell loss will not explain the fluctuating canal paresis to caloric stimulation. In contrast, the published evidence is that rotational testing of semicircular canal function in MD patients typically shows little reduction in function and even enhancement of vestibulo-ocular reflex gain, at least in the early stages of the disease. Here, we offer a novel explanation for this dissociation. We propose that hydropic expansion of the lateral canal membranous labyrinth permits convective recirculation within the duct that allows dissipation of the hydrostatic force that would normally cause cupular displacement and nystagmus in the caloric test.
journal_name
Ann N Y Acad Scijournal_title
Annals of the New York Academy of Sciencesauthors
McGarvie LA,Curthoys IS,MacDougall HG,Halmagyi GMdoi
10.1111/nyas.12687subject
Has Abstractpub_date
2015-04-01 00:00:00pages
58-62eissn
0077-8923issn
1749-6632journal_volume
1343pub_type
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