Ménière's disease

(Redirected from Meniere's disease)

Background

  • Occurs due to increased endolymph within the cochlea and labyrinth (endolymphatic hydrops)
  • First attack usually occurs in patients >65yrs
  • Usually is unilateral but may become bilateral with time

Clinical Features

  • Episodes of sudden-onset vertigo with nausea/vomiting
    • Can include "drop attacks" where the patient feels knocked to the ground
    • 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 patient is well (although decreased hearing and constant tinnitus may persist)

Differential Diagnosis

Vertigo

Evaluation

Management

Disposition

  • Refer to ENT for further evaluation and management
  • Surgery may include vestibular nerve section (surgical or chemical), endolymph sac decompression, endolymphatic-subarachnoid shunt, or labyrinthectomy

References

  1. Lorenzi MC, Bento RF, Daniel MM, Leite CC. Magnetic resonance imaging of the temporal bone in patients with Ménière's disease. Acta Otolaryngol. 2000 Aug. 120(5):615-9.
  2. Minor LB, Schessel DA, Carey JP. Ménière's disease. Curr Opin Neurol. 2004 Feb. 17(1):9-16.
  3. Sajjadi H. Medical management of Meniere's disease. Otolaryngol Clin North Am. 2002 Jun. 35(3):581-9, vii.
  4. Pullens B, Giard JL, Verschuur HP, van Benthem PP. Surgery for Ménière's disease. Cochrane Database Syst Rev. 2010 Jan 20. CD005395.
  5. Barrs DM. Intratympanic corticosteroids for Meniere's disease and vertigo. Otolaryngol Clin North Am. 2004 Oct. 37(5):955-72, v.