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Meniere's disease: peripheral or central origin. A neuroanatomical study.

Previous clinical and histological studies have suggested that the aetiology of Meniere's disease should be sought not only in the endolymphatic hydrops, but also in pathological changes of the brain and brain stem. Moreover, neuropsychological studies have indicated some centralization of the disease, whether it be primary or secondary. In order to elucidate this problem further we have examined the temporal bones and brains of 4 patients with Meniere's disease, who died of diseases unrelated to the inner ear or the central auditory and vestibular pathways. Endolymphatic hydrops was found in 6 temporal bones to a varying degree, as well as degeneration of the ganglion cells. The brain stem was divided by many horizontal sections from the rostral border of the superior colliculi above, to 15 mm caudal to the border between pons and medulla below. The principal nuclei and fascicles, the intra- and extraparenchymatous vessels and the leptomeninges were examined. The morphology of ganglion and glial cells was studied. Myelin sheaths were investigated for focal or diffuse demyelination, and the axons were observed. In addition, vessels and leptomeninges were studied for atherosclerosis and fibrosis. The brain autopsies did not reveal any changes, either locally or diffusely, which could support central pathoanatomical lesions as being responsible for the symptoms in Meniere's disease.