Meniere's Disease

Question 1

Define Meniere’s disease.

Answer 1

Meniere’s disease (MD) or Meniere syndrome is an auditory disease characterised by an episodic sudden onset of vertigo, low-frequency hearing loss (in the early stages of the disorder), low-frequency roaring tinnitus, and the sensation of fullness in the affected ear.

Question 2

Explain the aetiology/risk factors of Meniere’s disease.

Answer 2

Recent viral infection
Genetic predisposition
Autoimmune disease

Question 3

Summarise the epidemiology of Meniere’s disease.

Answer 3

MD is primarily a disease of adulthood, although several cases have been reported in children. Onset usually occurs in the fourth decade. No racial differences have been clearly reported, and around 50% of patients with this diagnosis present with a family history of MD. It is slightly more common in females, with a 1.1:1 female-to-male ratio.

Question 4

Recognise the presenting symptoms of Meniere’s disease.

Answer 4

Vertigo
Hearing loss
Tinnitus
Aural fullness

Question 5

Recognise the signs of Meniere’s disease on physical examination.

Answer 5

Positive Romberg’s test

Fukuda’s stepping test: Turns towards the affected side when asked to march in place.

Question 6

Identify appropriate investigations for Meniere’s disease and interpret the results.

Answer 6

Pure-tone air and bone conduction with masking

Speech audiometry

Tympanometry/immittance/stapedial reflex levels
Oto-acoustic emissions (OAE)