Object. Aim of our study was to establish some peculiar features of Ménière's Disease (MD) in a group of elderly MD patients, in which the first vertigo spell happened when over 65 years old. Material and Methods. We analyzed a group of 73 younger than 65-years-old and a group of 30 elderly MD patients. All patients underwent a neurotological evaluation, an anamnestic evaluation including a lifetime history of migraine, and blood withdrawal for autoantibody screening. Results. Some differences were found between elderly and younger MD patients. Elderly MD patients presented a higher prevalence of Tumarkin attacks and a lower prevalence of lifetime history of migraine; moreover, they presented a faster develop of hearing loss and vertigo spells than a subgroup of 32 younger patients matched for the duration of illness. Conclusions. Some clinical features of MD in elderly have been pointed out. Particularly, the lower rate of migrainous history and positivity for autoantibodies often associated with MD, in our opinion, support the hypothesis of a vascular disorder acting as a predisposing factor for MD in elderly. 1. Introduction Ménière’s Disease (MD) is an inner ear disorder, characterized by recurrent episodes of rotational vertigo, coupled with fluctuating hearing loss and tinnitus. According to The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF), the diagnostic criteria for definite MD are the presence of two or more episodes of vertigo of at least 30？min with hearing loss plus tinnitus and/or aural fullness [1]. The prevalence of MD is 190 cases per 100000, and this value increases in the elderly [2]. The commonly accepted pathogenesis of MD is a raised endolymphatic pressure (hydrops), although a direct relationship between MD and endolymphatic hydrops is unproven [3, 4]. In the last few decades, several studies have analyzed possible etiological mechanisms and correlations with other diseases [5–14]. Epidemiological studies support the possibility of a correlation between MD and migraine. MD patients present a prevalence of migraine between 43% and 56%, which is significantly higher than the estimated 10% in the normal population [10, 11]. Migraine is considered per se a causal factor of recurrent vestibular symptoms, including both true rotational vertigo and subjective vertigo [5–15]; there is clinical evidence that migraine may damage the inner ear causing permanent hearing loss or vestibular deficit [16], and in children a fluctuating hearing loss has been considered as a migraine equivalent [17]. It has been
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