Role of the GP
GPs have an important role in the management of patients with Ménière’s disease. It is important to recognise the chronic nature of Ménière’s disease and to differentiate it from more common causes of transient vertigo, such as BPPV, vestibular neuritis and vestibular migraine. Providing education about the natural history of Ménière’s disease, ways of implementing and sustaining dietary (low sodium) and lifestyle (regular sleep and exercise) changes can go a long way to improving patients’ quality of life.
Referral to a specialist is preferable to establish the correct diagnosis and to formulate a treatment plan. Some practice points about Ménière’s disease are summarised in Box 4.
An attack of Ménière’s disease can be a frightening experience for patients and their families. It occurs suddenly and without warning. Later in the disease, hearing loss and tinnitus can become intrusive, particularly in bilateral cases. In patients with classical Ménière’s disease, a careful history and a simple audiogram are usually sufficient to make the diagnosis. A carefully designed, stepwise treatment plan involving dietary and lifestyle changes and medication can stabilise the symptoms and greatly improve patients’ quality of life. MT
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