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Of the 441 patients of Meniere's disease treated at the Neurotology Clinic of Toranomon Hospital from 1969 to 1983, 330 were observed for a long time. The longest period of observation was 15 years.1. Changes of symptoms and functions1) Hearing: same. . 72%, improved. . 15%, worse. . 13%.2) Vertigo: no vertigo.. 57%, very mild dizziness 43/%.3) Caloric test: same. . 95%, worse. . 5%.2. Bilateral Meniere's disease appeared in 24 cases cases (5%).3.Therapy1) Conservative therapy2) Patients with frequent vertigo attacksWhen the glycerol test was positive, endolymphatic sac surgery was performed. When the glycerol test was negative and hearing was preserved, streptomycin sulfate infusion of the middle ear was performed. When the hearing impairment was severe, labyrinthectomy or VIIIth nerve section was done.

A 67-year-old woman developed clinic al findings consistent with herpes zoster of the left ear, localized encephalitis and meningitis. These signs included herpes of the left external ear and soft palate, VIIth and VIIIth nerve disfunction, ataxia and electro-nys-tagmographic (ENG) abnormalities ; defective opto-kinetic nystagmus and saccadic pursuit towards the right.Treatment with adenin arabinoside (Ara-A) resulted in rapid improvement.The importance of CSF examination including cell counts and CSF-IgG index, ENG and EEG was emphasized.