Ménière Syndrome
Attacks of vertigo lasting hours to days. Hearing loss, tinnitus occur within attacks early in course; permanent later. Sense of fullness in affected ear often accompanies attacks.
Prevalence 1:500. Women may be more affected. Vertigo absent in 10%.
Etiology and Pathogenesis
Due to pressure surges in endolymphatic compartment of inner ear (endolymphatic hydrops).
May be idiopathic (Ménière disease) or secondary to specific causes (Ménière syndrome): post-traumatic (inner ear concussion, temporal bone fracture), endolymphatic fistula, postinfectious or inflammatory (labyrinthitis, meningitis, Lyme disease, otosyphilis), congenital (anatomic abnormality of inner ear), tumor (e.g., vestibular Schwannoma), vertebrobasilar insufficiency, autoimmune.
Symptoms and Signs
Onset unilateral in 95%. If bilateral: consider autoimmune cause.
Tinnitus: roaring, machinery-like; fluctuating. Vertigo: nausea, vomiting, sweating, pallor often present, due to peripheral origin.
Examination: during attack, horizontal nystagmus beating toward affected ear.Related posts:
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