Meniere's disease

Question 1

What is meniere’s disease?

Answer 1

idopathic disorder causing repeat attacks of vertigo

Question 2

what is meniere’s disease caused by?

Answer 2

increased in endolymphatic pressure

Question 3

what is the clinical presentation of meniere’s disease?

Answer 3

1. unilateral
2. triad of;
   - severe paroxysmal vertigo

• sensorineural hearing loss
• tinnitus

Question 4

How long does each epsiode last for?

Answer 4

episodes can last for hours and resolve for hours

Question 5

what is the prognosis of meniere’s disease over time?

Answer 5

1. during remission between attacks, symptoms will improve

2. over time repeated attacks result in sensorineural hearing loss worsening over time

Question 6

what drugs may be prescribed to help?

Answer 6

1. Buccastem / prochloperazine during acute attacks

2. betahistine medication to be taken regularly

Question 7

what are the differential dx?

Answer 7

1. vestibular neuritis
2. BPPV
3. vestibular beuritis

Question 8

what is the mechanism of action of Buccastem?

Answer 8

1. prochloperazine
2. dopamine receptor antagonist
3. antiemetic and classed as vestibular sedative to reduce the overactivity of the labryrinth

Question 9

what is the mechanism of action of betahistine?

Answer 9

1. to be taken regularly
2. strong antagonist for histamine H2 receptor
3. weak agonist for Histamine H1 receptor - stimulate inner ear H1 causing vasodilation and reduces the pressure within the endolymph system

Question 10

what lifestyle mx can be made?

Answer 10

1. avoid food with high salt content as this can cause pressure in the inner ear to fluctuate
2. labyrinthine stimulants are - alcohol, caffeine, stress, illness

Question 11

what other treatment options for meniere’s

Answer 11

1. vestibular rehab therapy

2. hearing aids for hearing loss