Neuro-ophthalmology and neuro-otologyMénière's diseaseMinor, Lloyd Ba; Schessel, David Ab; Carey, John PaAuthor Information aDepartment of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland and bDepartments of Otolaryngology and Neurosurgery, George Washington University, Washington, DC, USA Correspondence to Dr Lloyd B. Minor MD, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Outpatient Center, 601 N. Caroline St., Baltimore, MD 21287-0910, USA Tel: +1 410 955 3403; fax: +1 410 955 0035; e-mail: email@example.com Current Opinion in Neurology: February 2004 - Volume 17 - Issue 1 - p 9-16 Buy Abstract Purpose of review Ménière's disease is characterized by spontaneous attacks of vertigo, fluctuating sensorineural hearing loss, aural fullness, and tinnitus. The pathologic process involves distortion of the membranous labyrinth with the formation of endolymphatic hydrops. This review describes the pathogenesis and etiology as well as the diagnosis and treatment of Ménière's disease. Recent findings Initial management of Ménière's disease can involve a low-salt diet and a diuretic. Treatment with intratympanic injection of gentamicin can be beneficial when vertigo persists despite optimal medical management. Recent studies have shown that gentamicin reduces vestibular function in the treated ear, although complete ablation of this vestibular function is not typically required in order to achieve control of vertigo. Summary Vertigo is often the most debilitating symptom associated with Ménière's disease. Many treatment options exist for the management of vertigo. Intratympanic injection of gentamicin (low dose) can be used in patients for whom vertigo has not been controlled by medical measures. Ongoing research is providing a greater understanding of the effects of gentamicin on vestibular function and of the mechanisms through which gentamicin leads to control of vertigo. © 2004 Lippincott Williams & Wilkins, Inc.