Ménière's disease

Question 1

recurrent episodes of […], tinnitus and hearing loss ([…])a sensation of aural […] or […] is now recognised as being common

Answer 1

recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural)
a sensation of aural fullness or pressure is now recognised as being common

Question 2

Other features

[…] and a positive […] test
episodes last […] to […]
typically symptoms are […] but bilateral symptoms may develop after a number of years

Answer 2

Nystagmus and a positive Romberg test
episodes last minutes to hours
typically symptoms are unilateral but bilateral symptoms may develop after a number of years

Question 3

Advice
1. When do symptoms resolve?
2. Is there a degree of hearing loss?

Answer 3

symptoms resolve in the majority of patients after 5-10 years
Yes

Question 4

Management
ENT assessment is required to confirm the diagnosis
patients should inform the […]. The current advice is to […] driving until satisfactory control of symptoms is achieved
acute attacks: buccal or intramuscular […].
Admission is sometimes required
prevention: […] and vestibular rehabilitation exercises may be of benefit

Answer 4

ENT assessment is required to confirm the diagnosis
patients should inform the DVLA. The current advice is to cease driving until satisfactory control of symptoms is achieved
acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required
prevention: betahistine and vestibular rehabilitation exercises may be of benefit

Question 5

Management
ENT assessment is required to confirm the diagnosis
patients should inform the […]. The current advice is to […] driving until satisfactory control of symptoms is achieved
acute attacks: buccal or intramuscular […].
Admission is sometimes required
prevention: […] and vestibular rehabilitation exercises may be of benefit

Answer 5

ENT assessment is required to confirm the diagnosis
patients should inform the DVLA. The current advice is to cease driving until satisfactory control of symptoms is achieved
acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required
prevention: betahistine and vestibular rehabilitation exercises may be of benefit