Meniere's Disease in Adults Flashcards
What is the typical history associated with Meniere’s disease?
Recurrent episodes of vertigo lasting minutes to hours. Fluctuating hearing loss, tinnitus, and aural fullness. History of triggers such as high salt intake, stress, or alcohol.
What are the key physical examination findings in Meniere’s disease?
Spontaneous nystagmus during vertigo episodes. Fluctuating sensorineural hearing loss on audiometry. Normal neurological exam.
What investigations are necessary for diagnosing Meniere’s disease?
Audiometry to assess hearing loss. Electrocochleography (ECoG) to assess endolymphatic hydrops. MRI to rule out other causes of vertigo.
What are the non-pharmacological management strategies for Meniere’s disease?
Low-sodium diet and avoidance of triggers. Vestibular rehabilitation exercises. Educate on the chronic nature of the condition.
What are the pharmacological management options for Meniere’s disease?
Diuretics (e.g., hydrochlorothiazide) to reduce endolymphatic fluid. Antiemetics (e.g., meclizine) for symptom relief during attacks. Intratympanic steroid injections for refractory cases.
What are the red flags to look for in Meniere’s disease patients?
Severe or frequent vertigo attacks. Sudden, severe hearing loss. Neurological symptoms: weakness, numbness, ataxia.
When should a patient with Meniere’s disease be referred to a specialist?
Refractory Meniere’s disease not responding to medical treatment. Consideration for surgical intervention (e.g., endolymphatic sac decompression). Need for specialized vestibular testing or treatment.
What is one key piece of pathophysiology related to Meniere’s disease?
Excessive accumulation of endolymph in the inner ear. Leads to distention of the membranous labyrinth. Causes episodic vertigo, hearing loss, and tinnitus.
