Meniere's disease
| Headline | |
|---|---|
| Etiology | over production/↓ absorption of endolymph? |
| Epidemiology | Risk factors: autoimmune history, fhx, recent viral illness |
| Clinical presentation | sudden onset of vertigo, sensorineural hearing loss, tinnitus, and sensation of fullness in the affected ear |
| Diagnostic investigations | None which can be easily done in ED - CKS recommends ENT referral Rule out MS, space occupying lesions, BPPV, vestibular neuronitis (justified in doing CT head for acute vertigo) |
| Management | Advise attacks usually self-resolve within 24h and max 5-7 days. Lifestyle: Na restriction (!), caffeine and alcohol consumption Pharm: - antihistamines might be used... evidence varies. - Steroids if sudden hearing loss. - Betahistine to minimise frequency and severity of attacks Mechanical: tinnitus retraining, hearing aids... Surgical: endolymphatic sac surgery |
from CKS:
A probable diagnosis requires all of the following criteria:
- Two or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours.
- Fluctuating aural symptoms (hearing loss, tinnitus, or fullness) in the affected ear.
- Not better accounted for by an alternative vestibular diagnosis.