meniere's disease

Question 1

what is menieres disease?

risk factors?

Answer 1

Meniere’s disease is a disorder affecting the inner ear which can affect balance and hearing.

May be associated with endolymphatic hydrops (raised endolymph pressure in the membranous labyrinth of the inner ear).

Suggested risk factors include:
Autoimmunity.
Genetic susceptibility.
Metabolic disturbances involving levels of sodium and potassium in the inner ear.
Vascular factors (there is an association between migraine and Meniere’s disease).
Viral infection.
Head trauma.

Question 2

Ddx criteria for Meniere’s?

Answer 2

A definite diagnosis of Meniere’s disease requires all of the following criteria:

1. Vertigo — at least two spontaneous episodes lasting between 20 minutes and 12 hours.
2. Fluctuating hearing, tinnitus, and/or perception of aural fullness in the affected ear.
3. Hearing loss confirmed by audiometry to be sensorineural, low-to-mid frequency, and defining the affected ear on one or more occasions before, during, or after an episode of vertigo.
4. No alternative vestibular diagnosis.

Needs ENT referal and full assessment for official ddx

Question 3

rx?

Answer 3

To help alleviate nausea, vomiting, and vertigo in people with acute Meniere’s disease, a short course of prochlorperazine or an antihistamine (for example cinnarizine, cyclizine, or promethazine teoclate) should be considered.

A trial of BETAHISTINE can be considered to reduce the FREQUENCY and severity of attacks.

If symptoms are severe enough, people may require hospital admission for intravenous (IV) labyrinthine sedatives and fluids to maintain hydration and nutrition.