Gadolinium-enhanced inner ear magnetic resonance imaging of Lermoyez syndrome in the right ear and Meniere’s disease in the left ear: A rare case report

We present the case of a 71-year-old man who developed Meniere's disease (MD) in the left ear followed by Lermoyez syndrome (LS) in the contralateral ear. The patient was treated for left-sided MD from ages 37 to 63. Upon reaching 64 years of age, the patient's Meniere's attacks disappeared. The left hearing loss stabilized at 70 dB. Eight years later, repetitive right-side tinnitus and hearing loss occurred, followed by episodic vertigo and subsequent hearing improvement consistent with LS. Gadolinium-enhanced magnetic resonance imaging of the inner ear revealed mild endolymphatic hydrops (EH) in the right cochlea and vestibule. The signal intensity ratio of the perilymphatic enhancement in the right ear with LS was higher than that in the left ear with MD, indicating higher disease activity in the right ear. The pathophysiology of LS was considered as EH. Although Lermoyez's attacks were initially intractable, they eventually subsided with water intake therapy.