Most people referred to ENT with Meniere’s disease do not have the condition, which is NOT associated with mild or brief episodes of vertigo.
Meniere’s disease is characterised by:
- SEVERE AND DISABLING VERTIGO – fully incapacitating – so that the patient cannot stand or walk. Vertigo attacks are usually prolonged (persisting for hours or days).
- SIGNIFICANT unilateral HEARING LOSS – initially fluctuating and then more profound with progression.
- Unilateral TINNITUS – classically ‘roaring’, initially during attacks and eventually more persistent.
Unilateral ‘AURAL FULLNESS’ may be experienced by some – a sensation of pressure in the ear, or ear discomfort, often present in advance of a vertigo attack.
Any of these symptoms may predominate, and attacks can occur in clusters.
NICE has produced a helpful CKS – please see here for details. A low salt / caffeine diet may help and the Meniere’s Society gives further detail here, as well as extensive other information.
Who to refer:
Where a diagnosis of Meniere’s needs to be confirmed – patients with disabling, prolonged vertigo attacks with associated symptoms (see above).
Please first:
- Consider treating for BPPV as often both are present
- Advise about a low salt and caffeine diet
- Ask the patient to complete a symptom diary.
Who not to refer:
- Those with tinnitus but no other ENT symptoms – see Tinnitus page for advice about self-management or referral to Audiology.
- Those with symptoms suggestive of BPPV – see BPPV for details of referral to Audiology.
How to refer:
Please refer through SCI Gateway to ENT at LAURISTON ONLY.
The Meniere’s Society is the UK’s leading charity for people with vestibular (inner ear) disorders causing dizziness and imbalance. Please see here for further details.
