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Feature Article

Ménière’s disease. A guide to management

Melville da Cruz
OPEN ACCESS

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.

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Conclusion

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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COMPETING INTERESTS: None.

 

References

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6.    Chen L, Bradshaw A, Welgampola MS. Evaluation of the patient with acute vertigo. Med Today 2012; 13(6): 25-32. 
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8.    Watson S. Vertigo and migraine: ‘How can it be migraine if I don’t have a headache?’ Med Today 2011; 12(12): 36-43. 
9.    Thirlwall AS, Kundu S. Diuretics for Ménière’s disease or syndrome. Cochrane Database Syst Rev 2006; (3): CD003599.
10.    da Cruz M. Severe hearing loss in adults: is cochlear implantation an option? Med Today 2012; 13(4): 43-48.
11.    da Cruz M. Alleviating the distress of tinnitus: a phantom sound. Med Today 2012; 13(7): 16-22.

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Associate Professor da Cruz is an Ear Nose and Throat Surgeon at Westmead Hospital, University of Sydney, and a Cochlear Implant Surgeon at Sydney Cochlear Implant Centre, Sydney, NSW.