foreign [Applause] [Music] ers.com in this video I'm going to be going through Meniere's disease and you can find written notes on this topic at 02 finals.com slash Meniere's disease or in the ear nose and throat section of the zero definals surgery book so let's jump straight in Meniere's disease is a long-term inner ear disorder that causes recurrent attacks of vertigo and symptoms of hearing loss tinnitus and a feeling of fullness in the ear a top tip for you remember the typical Triad of symptoms in Meniere's disease as this is commonly tested in exams and these three symptoms are hearing loss vertigo and tinnitus let's start with the pathophysiology Meniere's disease is associated with the excessive buildup of endolymph in The Labyrinth of the inner ear which causes a higher pressure than normal within the Labyrinth and disrupts the sensory signals this increased pressure of the endolymph is called endolymphatic high drops so what's the presentation the typical patient is 40 to 50 years old presenting with unilateral episodes of vertigo hearing loss and tinnitus vertigo in Meniere's disease comes in episodes these last for 20 minutes to several hours before they settle these episodes can come in clusters over several weeks followed by prolonged periods often months without vertigo symptoms vertigo is not triggered by movement or posture in Meniere's disease the hearing loss in Meniere's disease typically fluctuates at first associated with the vertigo attacks then gradually it becomes more permanent it is a sensory neural hearing loss generally unilateral and it affects the lower frequencies first tinnitus initially occurs with episodes of vertigo before eventually becoming more permanent along with the hearing loss and this is also usually unilateral other symptoms with Meniere's disease can include a sensation of fullness in the air unexplained Falls or drop attacks without any loss of consciousness and imbalance and the imbalance can persist after the episodes of vertigo have resolved spontaneous nystagmus which is where the eyes rapidly flick side to side may be seen during an acute attack of vertigo this is usually in only one direction or unidirectional so how do you make a diagnosis the diagnosis of Meniere's disease is clinical based on the signs and symptoms the diagnosis will be made by an ear nose and throat or ENT specialist patients will need an Audiology assessment to evaluate their hearing loss the audiogram will show a sensory neural pattern unilateral and affecting the lower frequencies first Let's Talk About Management involves managing symptoms during an acute attack and prophylactic medication to reduce the frequency of the attacks for acute attacks the short-term options for managing symptoms include procloparazine or antihistamines for example cyclizine cenarazine and promethazine prophylaxis to reduce the frequency of attacks is with beta histine if you like this video consider joining the zero to finals patreon account where you get early access to these videos before they appear on YouTube you also get access to my comprehensive course on how to learn medicine and do well in medical exams digital flash cards for rapidly testing the key facts you need for medical exams early access to the zero to finals podcast episodes and question podcasts which you can use to test your knowledge on the go thanks for watching and I'll see you in the next video