Long term inner ear disorder that causes recurrent attacks of vertigo and symptoms of hearing loss and tinnitus.
- It is believed to result from excess fluid accumulation in the labyrinth, leading to increased pressure within the membranous labyrinth of the inner ear.
- Ménière’s disease is the term for the idiopathic form of the disorder. If a cause is identified, it is referred to as Ménière’s syndrome
Causes/Factors
Presentation
Typical triad of symptoms commonly tested
- Hearing loss
- Vertigo
- Tinnitus
- Vertigo episodes last 20 minutes to several hours - clusters over several weeks followed by prolonged periods without symptoms. The vertigo is not triggered by movement or posture
- Hearing loss - typically fluctuates at first but then gradually becomes more permanent. Unilateral and affects low frequencies first
- Tinnitus initially occurs with episodes of vertigo before eventually becoming more permanent. It is usually unilateral.
Investigations
Probable clinical diagnosis:
A probable diagnosis of Ménière’s disease 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.
- Confirmation requires referral to ENT consultant and formal audiology assessment
Management
- For acute attacks symptom management include - prochlorperazine, antihistamines (cyclizine, cinnarzine and promethazine)
- Prophylaxis with betahistine
Complications/red Flags
- Falls
- Psychological and social impacts