Meniere's Disease

Question 1

What is Menieres disease?

Answer 1

Associated with the excessive built of fluid (endolymph) in the labyrinth in the inner ear, causing a higher pressure than normal (endolymphatic hydrops) disrupting sensory signals.

Question 2

Symptoms of Menieres disease?

Answer 2

Main three are:
1) Vertigo
2) Hearing Loss
3) Tinnitus

However there is also sensation of fullness in the impacted ear. Symptoms tend to come and go together.

Question 3

Long term or short term?

Answer 3

Long term.

Question 4

How rare?

Answer 4

1 in 1000

Question 5

How long is vertigo present for?

Answer 5

Episodes can last from 20 mins to uptown 8/12 hours. These clusters can last up to several weeks. Followed by a prolonged period (months) of no vertigo symptoms.

Question 6

Presentation of a patient with Menieres Disease:

Answer 6

• 40 - 50 Years Old
• Unilateral Episodes of Vertigo, Hearing Loss, Tinnitus
  -Sensation of fullness
• unexpected falls with no loss of consciousness (drop attacks)
• imbalance that persists until vertigo resolves
• Spontaneous Nystagmus (usually unidirectional)

Question 7

What about vertigo?

Answer 7

Vertigo is not triggered by movement and posture.

Question 8

Hearing loss?

Answer 8

Fluctuates at first,
Associated with vertigo,
Gradually more perminent,
A sensorineural hearing loss,
Affects low freq first,
Unilateral

Question 9

Tinnitus?

Answer 9

Initially with vertigo,
Eventually more prominent
unilateral

Question 10

Treatment

Answer 10

• Medication: Vestibular suppressant, Anti - euretics, diuretics to control balance
• Diet control
  VR to control symptoms
  hearing aids
  intratymapnic gentamicin
  surgery.