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Ménière Disease, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Disease of the inner ear

  • Classically unilateral ear involvement (may be bilateral in up to 40% of cases)

  • Characterized by recurrent spontaneous and episodic vertigo, sensorineural hear...

Diagnosis

  • Diagnosis based upon clinical symptoms and neurotologic evaluation

  • Definitive diagnosis currently can only be made postmortem, though MRI holds potential for definitive diagnosis

  • Diagnostic cr...

Treatment

Pre-Hospital

  • Vertigo and neurologic symptoms can represent a stroke

  • Rapid transport to ED

  • Protect patient from falling

  • Maintain patient in comfortable position

  • IV isotonic fluids for patients wit...

Follow-Up

Disposition

Admission Criteria

Patient refractory to acute control of vertigo and associated effects (e.g., dehydration from protracted vomiting) 

Discharge Criteria

  • Tolerate oral fluids

  • Steady g...

Pearls and Pitfalls

  • Ménière disease typically presents with the classic tetrad of vertigo, hearing loss, tinnitus, and aural fullness

  • Treatment focus is symptom relief, not cure

  • Discharged patients shou...

Additional Reading

  • Casani  AP, Piaggi  P, Cerchiai  N, et al. Intratympanic treatment of intractable unilateral Meniere disease: Gentamicin or dexamethasone? A randomized controlled trial. Otolaryngol...

Codes

ICD9

386.00 Meniere's disease, unspecified 

ICD10

  • H81.01 Meniere's disease, right ear

  • H81.02 Meniere's disease, left ear

  • H81.09 Meniere's disease, unspecified ear

  • H81.03 Meniere's disease, bilateral

  • H8...

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