Complex rehabilitation of patients with Ménière’s disease

Authors

Dr.med. Ágnes Szirmai (Budapest, Hungary)

Proceedings

XL Congress of the NES - Bydgoszcz - Poland

Topics

Neurootology
Equilibrium
Diseases
Neurootology
Equilibrium
Neurootology
Neurootology
Neurootologic therapy
Pharmacotherapy
Neurootology
Neurootologic therapy
Physiotherapy

Keywords

complex treatment, Ménière's disease, vertigo diary.

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Abstract

Abstract:
Ménière’s disease is a severe disorder of the inner ear. The disorder has several types: periodical type (40%), progressive type (27%), regressive type (20%) and a variable form (13%).
The treatment of the acute attack is quite easy, it contains antiemetic, antihistamines and benzodiazepines. The interval therapy has no evidence based rules.
The aims of the treatment or management are the control of the attacks, the improvement of balance, control of tinnitus, and the hearing preservation, and hearing aid fitting, if necessary.
In the Otoneurological department of the Semmelweis University more than 100 patients with Ménière’s disease are managed in a year. Most of the patients are treated with betahistine and salt-free diet. The next step of the treatment is hospitalization with parenteral vasoactive treatment and intratympanally administered corticosteroid treatment. Patients who are resistant for the treatment underwent a decision: chemical labyrinthectomy or saccotomy is necessary. The decision is based on the audiogram and the detailed analysis of the patient’s vertigo diary. The patient’s with constant balance disorder need complex vestibular rehabilitation. The complex vestibular rehabilitation contains long term medical treatment and rehabilitation training program. The balance training means optokinetic training during the hospitalization period and optokinetic and statokinetic exercises at home.
Author emphasizes the importance of vertigo diary in the management of Ménière’s disease.