Intractable benign paroxysmal positional vertigo in patients with Meniere's disease

Objective: To provide a detailed description of the coexistence of benign p aroxysmal positional vertigo (BPPV) and Meniere's disease in individuals an d to offer a possible mechanism that explains the findings in these patient s. Study Design: Retrospective. Methods: Chart review. Results: Of 162 pati ents diagnosed with Meniere's disease between January 1998 and January 1999 , 9 were found to have both "definite" Meniere's disease and "certain" BPPV , Meniere's symptoms preceded the onset of BPPV in all of our patients. Sev en of the 9 patients were female. Except for one patient who experienced BP PV bilaterally, BPPV was limited to the same ear as the Meniere's disease. All patients presented with intractable BPPV that did not respond completel y to otolith repositioning procedures. A detailed description of five patie nts is presented. Conclusion: Our data, in conjunction with that of others, suggest that Meniere's disease may predispose patients to intractable BPPV . Hydropically induced damage to the maculae of the utricle and saccule or partial obstruction of the membranous labyrinth may be possible mechanisms that explain the coexistence of Meniere's disease and BPPV.