Ménière’s Disease

Question 1

classic triad

Answer 1

hearing loss
vertigo
tinnitus

Question 2

pathophysiolgy

Answer 2

excessive endolymph

causing higher pressure than normal and disruption of sensory signals

Question 3

endolymphatic hydrops

Answer 3

increased pressure of endolymph

Question 4

typical patient

Answer 4

40-50yrs

unilateral vertigo, hearing loss, tinnitus

Question 5

features - vertigo

Answer 5

episodic, coming in clusters

not triggered by movement or posture

Question 6

features - hearing loss

Answer 6

fluctuates at first with vertigo attacks,
then gradually becomes more permanent

sensorineural
unilateral

Question 7

features - tinnitus

Answer 7

occurs with vertigo episodes
then becomes more permanent

usually unilateral

Question 8

other symptoms

Answer 8

sensation fullness
unexplained falls - drop attacks
imbalance

spontaneous nystagmus during acute attack - unidirectional

Question 9

Mx - acute

Answer 9

prochlorperazine

antihistamines - cyclizine, promethazine

Question 10

Mx - prophylaxis

Answer 10

betahistine