Miniere’s disease

Ménière’s disease👉🏿Idiopathic endolymphatic hydrops👉🏿HSVT: headache, sensory neural hearing loss, episodic vertigo, Tinnitus. 👉🏿Dx: 2 episodes lasting 20 minutes to few hours Peripheral Vertigo during attacks👉🏿Fullness in the ear👉🏿Episodic N/V👉🏿Sensorineural hearing loss (low tones first) 👉🏿Weber louder normal ear 👉🏿Rinne : AC>BC 👉🏿20-60 yrs, peaks 40-60 yrs👉🏿Unilateral but 33% bilaterally 👉🏿Fakuda Test: marching in place with eyes close, patient turn towards the affected ear. 👉🏿Delayed catch up Saccad: eyes fixed on a target / head turned: eyes do not remain fixated on the target, instead of that transiently follow the head turning and then quickly & voluntarily return back to the target. 👉🏿Rx: Low salt diet, HCTZ +/- Triamterene; Scopolamine, Diazepam, ? Oral Steroid, counseling

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