Ménière's disease

Diagnosis is made on the basis of a thorough anamnestic clinical history (a diagnosis requires at least 2 crises of rotational vertigo lasting more than 20 minutes, accompanied by cochlear symptoms such as blocked ears and/or hearing loss), Tone audiometry indicating sensorineural hearing loss, usually at low pitch frequencies of tonal field ipsilateral to the auricular fold, and an MRI of the brain, which excludes pathology of central and/or vestibular nerve origin.

The main aim of treatment is to reduce the frequency of vertigo by using a prophylactic approach to attacks (beta-histine, calcium channel blockers, diuretics, steroids) together with special dietary rules (low-sodium diet and plenty of water between meals). If drug therapy alone is unsatisfactory, outpatient intratympanal cortisone injections and, only later, intratympanal gentamicin injections (ablative therapy) can be given if there is no therapeutic response. As a last resort, selective neuroectomy of the vestibular nerve may be performed in cases that do not respond to the previous approaches. Treatment of single vertigo, on the other hand, includes the use of steroids, diuretics and vestibulodepressants (only for a short time and only for a single episode of vertigo).