Meniere’s disease – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?
January 5, 2021 5:30 amMeniere’s disease is thought to be caused by inadequate absorption of endolymph, causing over accumulation, which distorts the membranous labyrinth. It maybe associated with hypothyroidism, hypoglycemia, and hyperlipidemia.
Sn. & Sx.:
- Triad: episodic tinnitus, sensorineural hearing loss, vertigo lasting minutes to hours
- Aural fullness
- Nystagmus
- Drop attacks (sudden falls without loss of consciousness)
- Unilateral symptoms
- Nausea and vomiting
dDx.:
- Benign paroxysmal positional vertigo
- Cholesteatoma
- Acoustic neuroma
- Labyrinthitis
- Vestibular neuronitis
- Vertebrobasilar insufficiency
- Ototoxic drugs
Sequelae:
- Increased likelihood of accidents
Work up:
- Serum chemistry (electrolytes)
- Orthopedic testing (positive Romberg’s test and Hallpike maneuver)
- Imaging (CT)
Tx.:
- Antiemetics
- Low sodium diet
- Diuretics (hydrochlorothiazide, triamterene)
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This post was written by Omar Rifai