4 questions about Meniere's Disease

1. What is the cause?

Exact mechanism not completelely understood but it seems that overabundance of endolymph within the cochlea is the cause.

2. What are the classic manifestations of this disease?

Unilateral fluctuating sensorineural hearing loss, aural fullness, tinnitus and spells of disabling vertigo that typically last between 20 minutes and 24 hours (rarely longer. Longer attacks are more consistent with vestibular neuritis). The vertigo attacks are not provoked by movements as they often are with benign paroxysmal positional vertigo. Many patients have nonspecific dizziness and imbalance in between spells of vertigo as well.

3. How is Meniere's diagnosed?

In large part by clinical history and physical exam. If the diagnosis is unclear audiometry, vestibular testing and MRI can be obtained to exclude other pathology and to confirm the diagnosis.

4. How is it treated?

Decrease dietary sodium, caffeine, alcohol, tobacco use. Use diuretic. Vestibular suppressants, ie meclizine, for acute attacks. For patient who don't respond to medical treatment, surgical options (intratympanic gentamycin, endolymphatic sac decompression/shunt, vestibular nerve section, labyrinthectomy) can be considered.


Source

Rakel and Bope: Conn's Current Therapy 2008, 60th ed.