HYDROPS OF LABYRINTH

                                                    MENIERE' DISEASE

ETIOLOGY:The exact cause of the disease is still being investigated and likewise the pathogenesis but known triggers include Viral illness, Autoimmune reactions, Endocrinopathies, Allergies, Stress, Sodium and Water retention, Trauma of Head, Alcohol intoxication, Side effect of drugs e.g ototoxic antibiotic; Aminoglycosides

CLINICS:
 Main Signs: Hearing loss/Deafness,Dizziness/Vertigo,Tinnitus, Nystagmus, Aural Fullness
 Minors: Headache,change in heart activity during attacks, pale skin, cold sweat.

There is always a period of remission and exacerbation. The patient due to aural fullness can feel when the wave of attack is about to start. Attack period ranges from hour to several weeks. Based on this, patient has stages of disease;
First stage---- 1-2hours twice or thrice a year
Second stage--- 2-4hrs once a month
Third stage-----9-12hrs daily

Note that during remission, symptoms are not seen in patient except for Deafness that remains always.
Diagnostics:
Neurological examination
ENT examination;
Tuning fork test
Audiometry(subjective and objective form and this includes impedometry),
Vestibulometry
Electrocochleography (ECOG)
Electronystagmography (ENG) or videonystagmography (VNG)
Head MRI scan
Glycerol Test must be positive

Treatment
There is no known cure for this disease but it can be managed,Treatment is basically symptomatic,
Treat other diseases present in patient
Manage patient with Diuretics, Diet, Lifestyle changes and Physiotherapy.
Note that Labyrinthectomy is indicated in uncontrollable vertigo thou it doesn't cure illness but takes care of vertigo.
Prognosis in every patient can be determined by how well a doctor can manage the symptoms in patient and the course of illness in individual patient.