Meniere's disease: Difference between revisions
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==Differential Diagnosis== | |||
{{Vertigo DDX}} | |||
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Revision as of 12:33, 12 May 2015
Background
- Occurs due to increased endolymph within the cochlea and labyrinth
- First attack usually occurs in pts >65yrs
- Usually is unilateral but may become bilateral w/ time
Clinical Features
- Episodes of sudden-onset vertigo w/ nausea/vomiting
- Duration: usually 2-8hr
- Frequency: Ranges from several episodes per week to several times per month
- Roaring tinnitus
- Diminished hearing
- Fullness in affected ear
- Between attacks pt is well (although decreased hearing may persist)
Differential Diagnosis
Vertigo
- Vestibular/otologic
- Benign paroxysmal positional vertigo (BPPV)
- Traumatic (following head injury)
- Infection
- Ménière's disease
- Ear foreign body
- Otic barotrauma
- Otosclerosis
- Neurologic
- Cerebellar stroke
- Vertebrobasilar insufficiency
- Lateral Wallenberg syndrome
- Anterior inferior cerebellar artery syndrome
- Neoplastic: cerebellopontine angle tumors
- Basal ganglion diseases
- Vertebral Artery Dissection
- Multiple sclerosis
- Infections: neurosyphilis, tuberculosis
- Epilepsy
- Migraine (basilar)
- Other
- Hematologic: anemia, polycythemia, hyperviscosity syndrome
- Toxic
- Chronic renal failure
- Metabolic
Diagnosis
- Confirmed by ENT via glycerol testing or vestibular-evoked potentials
Treatment
- Treat vertigo symptomatically with scopolamine, antihistamines, or benzodiazepines
Disposition
- Refer to ENT