Ménière’s disease and its treatment

1. Big picture

Ménière’s disease is a peripheral vestibular disorder of the inner ear. For the exam, recognize the classic triad:

Recurrent spontaneous vertigo + fluctuating unilateral sensorineural hearing loss + tinnitus/aural fullness.

The key clinical difference from vestibular neuronitis and benign paroxysmal positional vertigo (BPPV) is the cochlear involvement: Ménière has hearing symptoms, while vestibular neuronitis and typical BPPV do not.

Current diagnostic criteria require recurrent vertigo attacks lasting 20 minutes to 12 hours for definite Ménière’s disease, plus audiometrically documented low- to mid-frequency sensorineural hearing loss and fluctuati