Master Meniere's Disease with Picmonic for Physician Assistant

Though the cause is unknown, Ménière’s disease leads to excessive endolymph accumulation in the membranous labyrinth of the inner ear. The volume of endolymph continues to increase until the membrane ruptures.

Patients develop episodic tinnitus, which is described as a continuous, low-pitched humming, or ringing sound. This often immediately precedes vertigo.

As the endolymph accumulates, it applies pressure to cochlear hair cells. This repeated damage to the cochlea from increased fluid leads to one-sided sensorineural hearing loss over time.

Vertigo is described as a whirling sensation, and patients can complain of dizziness. A specific complaint is a “drop attack,” where they may experience the feeling of being pulled to the ground.

In addition to vertigo, patients almost always develop nausea and vomiting. Sometimes, pallor and sweating can also be seen.

In addition to bedrest, anti-vertigo medications can be used for acute Ménière’s disease, like meclizine, which has the trade name Antivert. Antihistamines and benzodiazepines can also be used.

The symptoms of Ménière’s disease can be responsive to a low salt diet, and patients have shown improvement with this intervention.

If relief is not achieved in these patients, surgical cutting of the nerve, or removal of the labyrinth can be done to manage Ménière’s disease. This, however, leads to the loss of vestibular and cochlear hearing.