What are some of the common diagnoses that can cause vertigo?
Meniere’s disease/Endolymphatic hydrops
Meniere’s disease involves the combination of ear pressure, tinnitus, hearing loss, and vertigo, and is the result of excess pressure of endolymphatic fluid in the inner ear. However, atypical forms of Meniere’s disease may result in virtually any combination of the above symptoms. The disease typically persists for several months, and may then go into remission. The condition may then re-emerge after periods of stress, dehydration, or high salt intake. Both the hearing and balance function may diminish with such recurrences.
Meniere’s disease usually occurs in only one ear, but may involve both ears in 10% of patients.
The first stage of treatment for Meniere’s disease involves diuretics, salt restriction, oral steroids, aggressive oral hydration, allergy treatment, and avoidance of caffeine, alcohol, and stress.
The second stage of treatment involves injections of steroids or gentamicin into the ear, the minimally invasive Meniett device, or endolymphatic sac-mastoid shunt surgery.
The third stage of treatment involves such measures as a labyrinthectomy or vestibular nerve section. Fortunately, the third stage of treatment is rarely necessary.
Of note, there is considerable overlap in symptoms between migraine-associated dizziness and Meniere’s disease, and the former should be considered in patients for whom treatments for presumed Meniere’s disease prove ineffective.