Time course of episodes of definitive vertigo in Meniere's disease.

OBJECTIVE To evaluate the frequency and duration of episodes of definitive vertigo in Ménière's disease. DESIGN Prospective longitudinal study. SETTING Multiple tertiary referral centers. PATIENTS Five hundred ten individuals from 8 hospitals that met the American Academy of Otolaryngology-Head and Neck Surgery diagnostic criteria for definitive Ménière's disease. INTERVENTION Conservative treatment. MAIN OUTCOME MEASURE Frequency and duration of episodes of definitive vertigo during follow-up. RESULTS Ménière's disease affects both sexes and both ears equally, with onset generally in the fourth decade of life. The number of episodes of vertigo is greater in the first few years of the disease. Although episodes of vertigo that last longer than 6 hours are less frequent than shorter episodes, they occur with similar frequency throughout the natural course of the disease. The percentage of patients without episodes of vertigo increases as the disease progresses, and 70% of patients who did not have an episode of vertigo for 1 year will continue to be free of episodes during the following year. Thus, there is a relationship between the frequency of episodes in consecutive years, although this association decreases rapidly as the number of years increases. CONCLUSION The frequency of definitive episodes of vertigo in Ménière's disease decreased during follow-up, and many individuals reached a steady-state phase free of vertigo.