Lecture 8- Meniere Disease Flashcards Preview

HESP 632 - Medical Audiology > Lecture 8- Meniere Disease > Flashcards

Flashcards in Lecture 8- Meniere Disease Deck (11)
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1

What is Meneiere Disease?

Multifactorial disorder probably initiated by a combination of genetic and environmental factors

Associated with accumulation of endolymph in the cochlear duct and vestibular organs

2

What is Meneiere Disease characterized by?

- Episodic, spontaneous vertigo, usually accompanied by fluctuating SNHL, tinnitus, and aural fullness
- Cochlear symptoms may occur between episodes of vertigo
- Vertigo crises are more frequent during early ears of disease

3

What are the diagnostic criteria for Meneiere Disease?

- 2 or more episodes of spontaneous vertigo lasting between 20 minutes and 12 hours
- Low frequency SNHL in 1 ear, defined at least one occasion before, during, or after one of the episodes of vertigo
- Fluctuating hearing symptoms (HL, tinnitus, aural fullness) in affected ear
- There is no other diagnosis that better explains the vestibular symptoms

4

What is vertigo?

Sensation of movement in the absence of movement, or an altered sensation of movement during normal movement of the head

5

What are some triggers for vertigo attacks?

Dietary: caffeine, sodium

Sound: Tullio phenomenon

Pressure: Hennebert symptom/sign

6

What is a vertiginous episode?

Defined by the time the patient has to be immobile and cannot move

- Can be <20 minutes or >12 hours, but these are not common findings; other vestibular disorders should be considered

7

How is the affected ear determined?

Thresholds shift to at least 35 dB HL at 2 consecutive frequencies below 2 kHz (or 30 dB shift compared to contralateral ear)

8

Do SNHL and vertigo have to occur at the same time?

No

- SNHL may precede the onset of vertigo by months or years

- Recurrent vertigo may occur before the SNHL in weeks or months, but tinnitus or aural fullness are usually associated with the first episode of vertigo

9

When is Meniere Disease considered likely?

- 2 or more episodes of vertigo or dizziness, lasting between 20 minutes and 24 hours each
- Fluctuating hearing symptoms (SNHL, tinnitus, or aural fullness) in the affected ear
- There is no other diagnosis that better explains vestibular symptoms

10

What is the differential diagnosis for Meniere Disease?

- DFNA9, COCH mutation
- Autoimmune inner ear disease
- Stroke
- Cogan syndrome
- ELST
- CPA mass
- Susac syndrome
- Infectious causes (e.g., otosyphilis)
- 3rd window syndromes
- Vestibular migraine
- Vestibular schwannoma
- Vogt-Koyanagi-Harada syndrome

11

When should Familial Meniere Disease be considered?

- At least one first or second relative has definitive or probably Meniere
- May occur in 8-9% of cases of MD in European populations, but has been described in nearly all ethnic groups
- Typically fits AD inheritance, although mitochondrial recessive has been described
- DTNA, FAM136A