Ménière’s syndrome is paroxysmal vertigo with tinnitus and sensorineural (perceptive) hearing loss. The hearing loss may be slowly progressive, fluctuating or sudden. Where no organic cause can be discovered the condition is called Ménière’s disease. The syndrome is found in patients with bone disease involving the otic capsule such as otosclerosis, osteitis deformans or late syphilis. It may also follow labyrinthine trauma or be associated with a wide variety of diseases interfering with the blood supply to the brainstem or inner ear. Endolymphatic hydrops has been demonstrated in all these conditions, and it is believed that it may occur also in Ménière’s disease. Other causes of the syndrome include inflammatory or demyelinating disorders or tumours involving the eighth nerve. Many drugs have been used to treat Ménière’s disease, but with little success. Drugs investigated in recent years include cinnarizine (an antihistamine which has been used for vertigo and motion sickness), betahistine (an orally active histamine analogue) and hydrochlorothiazide.
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