Meniere's disease

Question 1

What is Meniere’s disease?

Answer 1

Recurrent episodes of:
Tinnitus
Paroxysmal vertigo
Unilateral fluctuating hearing loss (lasting up to an hour)

Question 2

Describe the aetiology of Meniere’s disease

Answer 2

Disturbed homeostasis of endolymph (fluid in the inner ear); impaired absorption/ overproduction

Question 3

List 6 symptoms of Meniere’s disease

Answer 3

Vertigo
Loss of hearing in affected ear + starts at low frequencies (initially may jus be with vertigo spells, then becomes constant)
Tinnitus: in affected ear  
Loss of balance  
Headaches  
N+V

Question 4

What tests may be positive in Meniere’s disease?

Answer 4

Romberg’s test: POSITIVE, feeling unsteady when eyes closed) indicates a proprioceptive issue
Fakuda’s stepping test: POSITIVE, turning towards affected side when asked to march in place with eyes closed

Question 5

What investigations may be used to indicate Meniere’s disease?

Answer 5

NO SPECIFIC TEST will confirm dx
Rinnes + Webers test
Speech recognition threshold (SRT)

Question 6

What is seen on Rinnes and Webers test in Meniere’s disease?

Answer 6

Unilateral sensorineural loss

Question 7

What is the result of a speech recognition threshold test in Meniere’s disease?

Answer 7

Negative (Meniere’s does not cause a SRT change)

Question 8

What other investigations may e used to exclude other differentials of Meniere’s disease?

Answer 8

MRI
Electrocochleography
Electronystagmography

Question 9

What treatment may be given to ease symptoms in Meniere’s disease?

Answer 9

Betahistane or steroid injections into the ear