Meniere’s disease

• Published in: BMJ (Online) Vol. 349; no. nov12 9; p. g6544
• Main Authors: Harcourt, Jonny, Barraclough, Kevin, Bronstein, Adolfo M
• Format: Journal Article Book Review
• Language: English
• Published: England British Medical Journal Publishing Group 12.11.2014; BMJ Publishing Group LTD
• Subjects: Ablation Techniques; Adrenal Cortex Hormones - therapeutic use; Automobile Driving; Betahistine - therapeutic use; CLINICAL REVIEW; Diuretics - therapeutic use; Ear, Inner - surgery; Humans; Meniere Disease - diagnosis; Meniere Disease - therapy; Risk Reduction Behavior; United Kingdom > UK
• DOI: 10.1136/bmj.g6544
• ISSN: 0959-8138; 1756-1833

Meniere's disease is often considered in the differential diagnosis of episodic dizziness, although it is not a common cause of new onset vertigo. Rather it is a disorder of the inner ear, characterised by recurrent attacks of self limiting vertigo. These attacks are associated with unilateral fluctuating low frequency sensorineural hearing loss, a sense of "fullness" in the affected ear (aural fullness), and tinnitus.1 Clinical findings are initially normal between attacks but later there is unilateral hearing loss and tinnitus. Treatment of the condition has not been evidence based in the past, but new treatments look promising. In this article we discuss what is known about the pathogenic process of Meniere's disease and consider the clinical presentation of the disease, its clinical course and prognosis, and what clinical features help to discriminate the condition from other diagnoses. We also examine the evidence for treatment.