Menière’s Disease

This syndrome was first described by Menière in 1861. It is characterised by fluctuating hearing loss, tinnitus and prolonged but gradually decreasing attacks of vertigo and nystagmus which may last for some hours. Endolymphatic hydrops and periodic ruptures in the membranes separating endolymph from perilymph give rise to intermediate potassium palsy of vestibular nerve fibres (Dohlman 1976). This striking triad made Menière’s disease the most popular but certainly the most frequently over-diagnosed vertigo syndrome. It is the fourth commonest cause of vertigo (Table 24.3) and chiefly affects those aged between 30 and 50 years, with irregular frequency of attacks and a tendency to bilateral involvement. Spontaneous improvement can occur a few years, or even a decade, after the onset of the condition.