Meniere's disease

Question 1

What is Meniere’s disease

Answer 1

Long-term inner ear disorder that causes recurrent attacks of vertigo and symptoms of hearing loss, tinnitus and fullness in the ear.

Question 2

Presentation of Meniere’s disease

Answer 2

Typically 40-60yrs
Triad of Hearing loss (sensorineural), Vertigo and Tinnitus
Sensation of fullness in ear
Periodic episodes - last 2-4 hours

Question 3

Pathophysiology of Meniere’s disease

Answer 3

Excessive buildup of endolymph in the labyrinth of the inner ear causing a higher pressure (endolymphatic hydrops) - disrupts sensory signals

Question 4

Differentials of Meniere’s disease

Answer 4

BPPV, Labyrinthitis, Migraine, Vestibular neuronitis, Postural HTN

Question 5

Risk factors for Meniere’s disease

Answer 5

Family history of Meniere’s, poor fluid drainage in ear

Cause unknown

Question 6

Management of Meniere’s disease

Answer 6

Anti-emetics e.g. Prochlorperazine
Antihistamines e.g. Cyclizine
Vestibular sedative - Betahistine
Lifestyle e.g. Lower alcohol, salt and caffeine
Surgery if severe - Endolymphatic sac decompression