A 45-year-old woman has episodic attacks of vertigo lasting 2–6 hours, fluctuating low-frequency sensorineural hearing loss, tinnitus, and a sensation of aural fullness in the left ear. Between attacks, hearing returns to near-normal. The most likely diagnosis and its underlying pathology are:
- A Meniere's disease; endolymphatic hydrops ✓
- B Benign paroxysmal positional vertigo; canalith displacement
- C Vestibular neuritis; viral inflammation of vestibular nerve
- D Acoustic neuroma; compression of VIII nerve
Correct answer: A. Meniere's disease; endolymphatic hydrops
Explanation
Meniere's disease is characterised by Lermoyez's tetrad: episodic vertigo (lasting 20 min to 24 h), fluctuating low-frequency SNHL, ipsilateral tinnitus, and aural fullness. The pathological substrate is endolymphatic hydrops — distension of the membranous labyrinth by excess endolymph. Dietary salt restriction, diuretics, and vestibular suppressants are first-line treatments.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.