Meniere's disease in the practice of a neurologist

Abstract

Meniere's disease (MD) is a chronic disease characterized by spontaneous recurrent attacks of vestibular vertigo, hearing loss, tinnitus, ear congestion, and other symptoms. Patients with acutely developed vestibular vertigo in most cases seek medical help from a neurologist. MD is characterized by the presence of endolymphatic hydrops, but there is no clear correlation between the severity of hydrops and the severity of clinical manifestations. The clinical presentation of MD is variable, with some patients having progressive auditory symptoms with occasional vertigo attacks, while others may have frequent vertigo attacks with minimal auditory symptoms. Diagnosis is based on a comprehensive assessment of the clinical picture, otoneurological examination, audiometry data, electrocochleography, vestibular evoked myogenic potentials; in complex cases, MRI of the inner ear with contrast enhancement is performed (currently, this method is not widely used in clinical practice) and MRI of the head to exclude intracranial pathology. Treatment of patients is aimed at relieving acute attacks of dizziness, informing the patient about the disease, prescribing a low-salt diet, betahistine or Arlevert administration to prevent attacks; in rare cases of ineffectiveness of conservative therapy, intratympanic administration of gentamicin or surgical methods of treatment are possible. The use of Arlevert in MD is discussed.