Meniere’s Disease

• What is the typical triad of symptoms for Ménière’s Disease?

  Hearing loss

  Vertigo

  Tinnitus
• What is Ménière’s disease?

  Long-term inner ear disorder - caused by increased fluid pressure in the endolymphatic spaces of the membranous labyrinth

  Causes recurrent attacks of vertigo, and symptoms of hearing loss, tinnitus and a feeling of fullness in the ear. 
• Pathophys - Meniere's disease

  Excessive buildup of endolymph in the labyrinth of the inner ear -> higher pressure in inner ear (endolymph) -> disrupts sensory signals -> endolymphatic hydrops
• What are the RFs for Meniere's disease?

  Age (typically between 20-50)

  FHx

  Recent viral infection
• What are the signs & symptoms of Meniere's disease?

  Sudden attacks of paroxysmal vertigo

  Associated deafness

  Tinnitus

  Attacks occur in clusters, with periods of remission where function is recovered

  Condition can be disabling -> pts bedbound

  Nausea & vomiting

  Fluctuating deafness

  Spontaneous nystagmus may be seen during an acute attack (usually unidirectional)
• How is Meniere's disease diagnosed?

  Clinical diagnosis

  Made by ENT specialist

  Pts need audiology assessment -> evaluate hearing loss
• What are the DDx of Meniere's disease?

  Vestibular neuritis

  Labyrinthitis

  Benign paroxysmal positional vertigo (BPPV)
• What is the management of Meniere's disease?

  Symptomatic management of acute attacks

  • prochlorperazine
  • antihistamine (e.g. cyclizine, cinnarizine, promethazine)

  Prophylaxis to reduce frequency

  • betahistine
• When do the symptoms of Meniere's disease resolve?

  5-10 yrs
• What are the possible complications of Meniere's disese?

  Falls

  Profound hearing loss