Category Archives: Menieres disease

Summer school of Audiology

Zajvaljujući prof. Komazecu koji je omogućio ovu izuzetnu edukaciju dodajem moj skromni doprinos na temu oboljenja unutrašnjeg uva po nazivu francuskog naučnika

+ zanimljiv link o striji vaskularis

Ukoliko imate bilo kakva pitanja, možete me kontaktirati mailom: dusan@bbf.rs
ili na facebook: dr.dusan.pavlovic

Program i najavu sledeće konferencije iz oblasti novina u dijagnostici i lečenju vestibularnih poremećaja – Belgrade Balance Forum – možete pogledati na: bbf.rs
A kako je bilo na prošlim forumima na youtube kanalu pod nazivom: Belgrade Balance Forum

Betahistine in treating Meniere’s disease patients

What is the long term efficacy of betahistine dihydrochloride on the incidence of vertigo attacks in patients with Meniere’s disease, compared with placebo?

METHODS:
The BEMED trial is a multicentre, double blind, randomised, placebo controlled, three arm, parallel group, phase III, dose defining superiority trial conducted in 14 German tertiary referral centres

Results of this interesting study you can find HERE

Overlap btw Meniere’s and Vestibular Migraine

How dificult is to differentiate these two disorders? You can find some observation which may help you in practice:
Accompanying Symptoms Overlap during Attacks in Menière’s Disease and Vestibular Migraine

Few days ago I saw the pt (45yr wom) with few attacks (three) of strong vertigo accompanied with nausea, vomiting, and pulsating headache. Attacks lasted 48hours and she felt dizzy next 5 days. She hasn’t have any auditory symptoms. She has migraine since she was 20. Exam during last two attacks relieved left-beating Ny.
Vestibular Migraine Caloric Test

  • Calorics show no labyrinth function at the right side
  • VHIT reduced bilaterally
  • cVEMP: absent at right side
  • oVEMP: absent at both sides
  • tonal audiometry: normal hearing

The first attack was 6yr ago and other two this year. Regarding history and her vestibular testing results, one would assume recurrent neuritis at right sides. But pulsating headache, the same one which she has during migraine attacks would favor vestiblar migraine as diagnosis. I doubt Meniere’s disease whenever the attack of vertigo lasts more than 24hour and also, she didn’t have any audiological symptoms jet. The explanation for right vestibular deficit would be ischemic insult as result of vasospasm during the migraneous attacks.

Pseudoconductive hearing loss at Meniere’s diseases

Pseudoconductive hearing lossHave you noticed conductive hearing loss in low tones in Meniere’s patients?
Some colleagues has, and published it:

Low frequency air-bone gap in Menière’s disease without middle ear pathology. A preliminary report

Cochlear conductive hearing loss in patients with Meniere’s disease


 

 

Patient with left-sided Meniere’s disease. He’s attack of aural fullness lasts more than 2 months.
Masking was adequate.

Meniere pseudoconductive hearing loss

Tuning fork and VEMP prove that there’s no conductive component of hearing loss.
Also, cVEMP was greater on the left, affected side (but not more than 30%)
Meniere VEMP