Meniere’s Disease
- 1. Meniere’s Disease Ade Wijaya, MD November 2017
- 3. Introduction First described by Prosper Meniere, 19 th century Disorder of inner ear Recurrent self-limiting vertigo Unilateral hearing loss and tinnitus during attack Bronstein A, Lempert T. Dizziness. A practical approach to diagnosis and management. Cambridge University Press, 2007. Fiorino F, Pizzini FB. MRI performed after intratympanic gadolinium administration in patients with Meniere’s disease. Correlation with symptoms and signs. Eur Arch Otolaryngol 2011;268:181-7.
- 4. Epidemiology 190 per 100.000 in the US 4th – 6th decade of life 24 % bilateral MD Woman > man Sporadic; 5-15 Related to allergy, autoimmune, migraine Nakashima, T., Pyykkö, I., Arroll, M. A., Casselbrant, M. L., Foster, C. A., Manzoor, N. F., ... & Young, Y. H. (2016). Meniere's disease.Nature Reviews Disease Primers, 2, nrdp201628. Harris JP, Alexander TH. Current-day prevalence of Meniere’s syndrome. Audiol Neurootol 2010;15:318-22. McCormick A, Fleming D, Charlton J. Morbidity statistics from general practice—fourth national study. 1991-1992. Office of Population Censuses and Surveys, 1995.
- 5. Pathophysiology Nakashima, T., Pyykkö, I., Arroll, M. A., Casselbrant, M. L., Foster, C. A., Manzoor, N. F., ... & Young, Y. H. (2016). Meniere's disease.Nature Reviews Disease Primers, 2, nrdp201628.
- 8. Diagnostic Barraclough K, Bronstein A. Diagnosis in general practice: vertigo. BMJ 2009;339:749-52
- 9. Diagnostic Harcourt, J., Barraclough, K., & Bronstein, A. M. (2014). Meniere’s disease. Bmj, 349, g6544.
- 11. Management Goals: 1. Relief acute symptoms 2. Prevent reccurence 3. Eliminate progression
- 12. Management Acute vertigo treatment: phenothiazine / antihistamine and benzodiazepine Prevent reccurence: betahistin, diuretic, corticosteroid, aminoglycoside surgery
- 13. Summary Meniere’s disease is a rare cause of new onset vertigo compared with more common conditions such as benign paroxysmal positional vertigo or vestibular migraine Pure tone audiometry is the most useful diagnostic test for Meniere’s disease Although Meniere’s disease has no definitive cure, medical management and in some cases intratympanic ablation using gentamicin considerably reduces symptoms and disability from the condition Open surgery should be a rare option for the condition Rehabilitation of audiovestibular loss is important and many patients may require psychological support