The outcome of patients with Menieres disease.
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Meniere;s disease is a frequent vestibular disease that occurs predominantly in the fourth decade of life. Diagnosis is mostly medical and is based on findings of vertigo, sensorineural hearing loss, tinnitus and aural fullness. AIM: To study the clinical findings of Meniere;s disease: age, duration of vertigo, tinnitus, hearing loss and aural fullness, and unilateral or bilateral involvement. METHOD: a retrospective study included 39 patients with a diagnosis of Meniere;s disease confirmed by electrocochleography, who were seen at a neuro-otology referral centre. Patients underwent a clinical examination, audiometry and bilateral transtympanic electrocochleography. Patients were separated into 2 groups: bilateral Meniere;s disease and unilateral Meniere;s disease. RESULTS: The mean age was 42.9 years; 72.5% were female. Fluctuation of hearing loss occurred in 54.5% of cases, and 65.7% had frequent attacks of vertigo. Bilateral disease was observed in 33.3%. The onset of the disease was earlier in the bilateral group (33.7 years) compared to the unilateral group (p= 0.0013). Duration of disease, tinnitus, hearing loss and aural fullness were similar between groups. CONCLUSION: Patients with bilateral Meniere;s disease had symptoms earlier than patients with unilateral disease. There was no difference between the groups in duration of disease and associated symptoms. (+info)
Epley's maneuver in benign paroxysmal positional vertigo associated with Meniere's disease.
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The effects of Epley's maneuver in benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease are controversial. AIMS: To evaluate the progression of positional vertigo and nystagmus after one or more of Epley's maneuvers in BPPV associated with Meniere's disease, and the recurrence of BPPV. METHOD: a retrospective study of 62 patients with BPPV associated with Meniere's disease, that underwent Epley's maneuver, and that were monitored during 12 months after elimination of positional nystagmus. RESULTS: One Epley's maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after elimination of nystagmus, positional vertigo was suppressed in 71.0% of the patients, improved in 27.4% and remained unaltered in 1.6%. Four weeks after elimination of positional nystagmus, all patients were asymptomatic. Recurrence of BPPV was seen in 19.4% of the cases, with elimination of the positional vertigo and nystagmus by means of the specific maneuver for the involved canal. CONCLUSION: In BPPV associated with Meniere's disease, vertigo and positioning nystagmus were eliminated with one, two or three Epley maneuvers. BPPV recurrence was resolved by using a specific maneuver for the affected canal. (+info)
Familial clustering of migraine, episodic vertigo, and Meniere's disease.
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OBJECTIVE: To evaluate the association between migraine, episodic vertigo, and Meniere's disease in families. STUDY DESIGN: Clinical report. SETTING: University Neurotology Clinic. PATIENTS: Index patients identified with Meniere's disease and migraine and their family members. INTERVENTION: Structured interview to assess a diagnosis of migraine, episodic vertigo, and Meniere's disease in 6 families. Genotyping was performed on 3 sets of twins to analyze monozygosity or dizygosity. MAIN OUTCOME MEASURES: Clinical history of migraine, episodic vertigo, and Meniere's disease. RESULTS: Six index patients and 57 family members were interviewed either by a senior neurologist in person or over the phone by a trained study coordinator. An additional 6 family members completed questionnaires by mail. All 6 index patients had Meniere's disease and migraine. Twenty-six (41%) of the 63 relatives met International Classification of Headache Disorders II criteria for migraine headaches. Thirteen (50%) of these 26 experienced migraine with aura. Three others experienced typical aura without headache. Seventeen (27%) of 63 family members experienced recurrent spells of spontaneous episodic vertigo. There was one twin pair in each of 3 families; 2 pairs were monozygotic and one was dizygotic. In each twin pair, one twin had migraine and Meniere's disease, whereas the other experienced migraine and episodic vertigo without auditory symptoms. CONCLUSION: The frequent association of episodic vertigo, migraine, and Meniere's disease in closely related individuals, including identical twins supports the heritability of a migraine-Meniere's syndrome, with variable expression of the individual features of hearing loss, episodic vertigo, and migraine headaches. (+info)
Imaging of endolymphatic and perilymphatic fluid at 3T after intratympanic administration of gadolinium-diethylene-triamine pentaacetic acid.
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