Meniere's Disease

Question 1

What is Meniere’s disease?

Answer 1

A disorder of the inner ear.

Characterised by recurrent attacks of vertigo, and symptoms of hearing loss, tinnitus and a feeling of fullness in the ear.

Question 2

What is the typical triad of symptoms in Meniere’s disease?

Answer 2

1) Hearing loss
2) Vertigo
3) Tinnitus

Question 3

Pathophysiology of Meniere’s?

Answer 3

Excessive build up of endolymph in the labyrinth of the inner ear, causing higher pressure than normal and disrupting the sensory signal.

Question 4

What is the increased pressure of endolymph in Meniere’s called?

Answer 4

endolymphatic hydrops

Question 5

Is hearing loss sensorineural or conductive in Meniere’s?

Answer 5

Sensorineural

Question 6

Features of Meniere’s?

Answer 6

Attacks of:

1) Hearing loss (sensorineural)

2) Vertigo

3) Tinnitus

4) Feeling of fullness in the ear

5) Nystagmus (unidirectional)

6) Positive Romberg test

7) Unexplained falls (“drop attacks”) without loss of consciousness

Typically symptoms are unilateral but bilateral symptoms may develop after a number of years

Question 7

Mx of ACUTE attacks of Meniere’s?

Answer 7

Buccal or IM prochlorperazine

Question 8

What is used in prevention of Meniere’s?

Answer 8

• Betahistine
• Vestibular rehabilitation exercises

Question 9

Prognosis of Meniere’s?

Answer 9

• symptoms resolve in the majority of patients after 5-10 years
• the majority of patients will be left with a degree of hearing loss
• psychological distress is common

Question 10

Describe sensorineural hearing loss in Meniere’s

Answer 10

Generally unilateral and affects low frequencies first.