Lecture on Meniere's Disease

Overview

• Meniere's disease is a long-term inner ear disorder.
• Causes recurrent attacks of vertigo, hearing loss, and tinnitus.
• Includes a feeling of fullness in the ear.
• Commonly tested triad of symptoms: hearing loss, vertigo, tinnitus.

Pathophysiology

• Associated with excessive buildup of endolymph in the labyrinth of the inner ear.
• Causes higher pressure than normal, disrupting sensory signals.
• Increased pressure termed "endolymphatic hydrops".

Presentation

• Typical patient: 40-50 years old.
• Symptoms: unilateral episodes of vertigo, hearing loss, tinnitus.
• Vertigo
  • Episodes last 20 minutes to several hours.
  • Can occur in clusters over weeks, followed by months without symptoms.
  • Not triggered by movement or posture.
• Hearing Loss
  • Fluctuates initially, then becomes permanent.
  • Sensorineural, generally unilateral, affects lower frequencies first.
• Tinnitus
  • Initially occurs with vertigo episodes, then becomes permanent.
  • Also usually unilateral.
• Other symptoms may include:
  • Fullness in the ear.
  • Unexplained falls or drop attacks without loss of consciousness.
  • Imbalance, persisting after vertigo resolves.
  • Spontaneous nystagmus during acute vertigo attack (unidirectional).

Diagnosis

• Clinical diagnosis based on signs and symptoms by ENT specialist.
• Audiology assessment needed to evaluate hearing loss.
• Audiogram shows sensorineural pattern, unilateral, affecting lower frequencies.

Management

• Acute Attack Management
  • Short-term symptom management with procloparazine or antihistamines (cyclizine, cinnarizine, promethazine).
• Prophylaxis
  • Beta histine to reduce frequency of attacks.

.