Meniere's Disease

Question 1

What causes meniere’s disease?

Answer 1

Unknown

Question 2

What happens, pathologically, in meniere’s disease?

Answer 2

There is a build up of excessive pressure and progressive dilation of the endolymphatic system.

Question 3

What age group (roughly speaking) and gender is it seen most in?

Answer 3

Middle aged

Equal sex distribution.

Question 4

What are some features of Meniere’s Disease?

Answer 4

• Recurrent episodes of vertigo (prominent symptom), tinnitus and hearing loss (sensorineural).
• A sensation of aural fullness or pressure is now recognised as being common
• Other features include 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 5

How long does it take for symptoms to naturally resolve?

Answer 5

5-10 years

Question 6

What disabling feature will patients be left with when it resolves?

Answer 6

A degree of hearing loss

Question 7

How should we manage Meniere’s disease?

Answer 7

• ENT assessment is required to confirm the diagnosis
• ACUTE attacks = buccal or intramuscular PROCHLOPERAZINE.
  
  • Admission is sometimes required
• Prevention: BETAHISTINE may be of benefit

Question 8

What is the driving advice for someone with Meniere’s disease?

Answer 8

Patients should inform the DVLA. The current advice is to cease driving until satisfactory control of symptoms is achieved