Teaching Video Neuroimages: Spontaneous Nystagmus Reversal in Acute Attack of Meniere Disease

A 65-year-old woman with right-sided Ménière disease experienced one of her usual and frequent acute vertigo attacks during eye movement recording (video 1). The attacks were associated with right-sided tinnitus, hearing loss, and vomiting. She initially demonstrated right-beating nystagmus, but after 2 minutes, the nystagmus gradually reversed and became left-beating (video 1). During the reversal, downbeat nystagmus was present temporarily. The left-beating nystagmus then persisted for 2 hours.

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