Vestibular Neuronitis, Labyrinthitis and Menieres Disease

Question 1

What is vestibular neuronitis?

Answer 1

prolonged vertigo for days - weeks

Question 2

What are the presenting features of vestibular neuronitis?

Answer 2

prolonged vertigo

Question 3

What is the pathophysiology of vestibular neuronitis?

Answer 3

normally viral - affects the superior vestibular nerve in the temporal bone

Question 4

What is Labyrinthitis?

Answer 4

prolonged vertigo for days - weeks

Question 5

What is the presentation of Labyrinthitis?

Answer 5

tinnitus
hearing loss - sometimes
affects whole inner ear

Question 6

What is the pathophysiology of Labryinthitis?

Answer 6

viral

Question 7

What is Menieres Disease?

Answer 7

vertigo lasting hours

uncommon - hard to treat

Question 8

What is the pathophysiology behind Menieres Disease?

Answer 8

pressure in the endolymph system

Question 9

What is the presentation of Menieres Disease?

Answer 9

recurrent, spontaneous, rotational vertigo with at least two episodes lasting >20mins
SENSORINEURAL HEARING LOSS ON AT LEAST ONE OCCASION
worsening tinnitus on the affected side

Question 10

How can Meniere periods be avoided?

Answer 10

reduce salt, alcohol, caffeine, stress, betahistine

Question 11

How can Menieres disease be treated?

Answer 11

tinnitus therapy
hearing aids
gromit inception
intratympanic steroids or gentamicin
vestibular nerve section - to disconnect it from the brain