![]() ![]() Viral (e.g., adenovirus) or bacterial (e.g., staphylococcus/streptococcus) can lead to complete hearing loss and vestibular crisis event with prolonged vertigo and/or hearing loss Not associated with hearing loss, tinnitus, or aural fullness short duration of vertigo episodes Positional vertigo lasting less than a minute May present with vision, skin, and joint problems Often progressive fluctuating bilateral hearing loss that is steroid responsive Dix-Hallpike maneuver with Frenzel goggles.Romberg, Fukuda, and pronator drift tests.Document peripheral sensation in all extremities.Complete physical examination including a comprehensive neurological examination.Evaluate family history of hearing and balance problems.Note the duration of vertigo and hearing loss episodes, as well as any potential triggers.Question the patient about the characteristics of vertigo, hearing loss, and earlier episodes of these symptoms.Differentiation between vertigo of central, peripheral, and cardiovascular origin.At least 2 episodes of vertigo or dizziness lasting 20 minutes to 24 hours.Probable Ménière’s disease can include:.Fluctuating aural symptoms (hearing loss, tinnitus, or fullness) in the affected ear.Audiometrically documented fluctuating low- to medium-frequency sensorineural hearing loss in the affected ear on at least 1 occasion before, during, or after one of the episodes of vertigo.Two or more spontaneous attacks of vertigo, each lasting 20 minutes to 12 hours.A full and accurate diagnosis may take months to attain.Significantly impacts the social functioning of the affected patient.Often slowly progressive to end-organ damage.Possibly caused by the accumulation of endolymphatic fluid in the cochlea and vestibular organ (endolymphatic hydrops).Ménière’s disease is an inner ear disorder characterized by intermittent, spontaneous episodes of vertigo, tinnitus, and hearing loss.Describe the clinical features of Ménière’s disease.Table of Contents Ménière’s disease Learning objectives
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