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Abstract: Meniere’s disease mainly presents clinically as recurrent episodes of vertigo, which may be accompanied by nausea, vomiting, pallor, cold sweats, and tinnitus. The etiology is unclear, and the underlying pathological changes are considered to be membranous vagal effusion. The patient came to our hospital with episodic vertigo with hearing loss. She came to our hospital with detailed inquiries about the related conditions and treatment plan, improved CT of head and ear, hearing test and other examinations, confirmed the diagnosis of Meniere’s disease, and then treated conservatively with medicine, and the patient’s vertigo and hearing loss improved.
Basic information】Female, 40 years old
Disease Type】Ménière’s disease
Hospital】Northern War Zone General Hospital
Date of consultation】November 2021
Treatment plan】Bed rest + medication (betahistine mesylate tablets + flunarizine hydrochloride capsules)
Treatment period】15 days of outpatient treatment
Effectiveness】The patient’s vertigo and hearing loss improved after medication
I. Initial consultation
The patient’s family members reported that the patient had two episodes of sudden vertigo 3 years ago, which occurred after overexertion and improved after rest, so the patient was not examined and did not take any medication. This time, the vertigo attack was accompanied by nausea and vomiting, but the patient was conscious and had hearing loss, and there was a high-pitched tinnitus and a feeling of swelling in the ears, which was especially obvious. The patient was advised to complete pure tone audiometry and acoustic conductance examination, which indicated neurological hearing loss and normal acoustic conductance, vestibular function examination indicated low vestibular function, and CT of the ear and head indicated no significant abnormality, and based on the patient’s symptoms and related examination results, the diagnosis of Ménière’s disease was suggested.
II. Treatment history
The patient was advised to rest in bed, not to move freely, to eat high protein, high vitamin, low fat and low salt food, and to gradually get out of bed after the symptoms were relieved, and was reassured that there was no organic lesion in the relevant examination, so there was no need to be overly nervous and not to have a burden of thought. Betahistine mesylate tablets and flunarizine hydrochloride capsules are commonly used in clinical practice, and their main function is to dilate blood vessels and suppress vertigo. If discomfort occurs during the course of medication, or if the condition further worsens, go to hospital for follow-up immediately.
III. Treatment effect
The patient came to the hospital for follow-up 1 week later and said that her mental state had improved significantly compared with that of last week, and she felt that her vertigo had disappeared, but she still had slight tinnitus and hearing loss. The patient was very satisfied with the treatment effect and was advised to continue to take betahistine mesylate tablets and flunarizine hydrochloride capsules to consolidate the treatment. After 15 days of medication, the patient’s mental state has been effectively improved, and the tinnitus and hearing loss have improved more than before, and the stuffy feeling in the ear has not appeared again, the medication is effective, the patient expressed satisfaction.
IV. Notes
We are glad to see that the patient’s symptoms are relieved after treatment. We suggest that the patient should avoid doing strenuous exercise in general and avoid excessive panic during vertigo attacks, so that he needs to rest in bed with his head flat and not swinging from side to side. Avoid smoking, drinking alcohol and staying up late in the night to ensure sufficient sleep, which is beneficial to recovery, and ensure a light diet, avoid spicy, stimulating and greasy food, pay attention to the diet structure and recommend low-fat and low-salt food. During the treatment period, it is necessary to ensure a positive and optimistic attitude, and to exercise properly to improve the resistance.
V. Personal insight
Meniere’s disease is a common clinical disease in otolaryngology, which can cause panic in the heart when it attacks. Regardless of the application of conservative treatment or surgical treatment, patients need to ensure a positive state of mind, which is conducive to the recovery of the disease.