Persistence of Non-Vertigo Symptoms in Meniere Disease During Remission – A Preliminary Report

Background: Though the absence of vertigo in Meniere disease is often interpreted as remission, patient-centered subjective assessment of quality of life remains the best indicator of such remission. Study Objective: To assess the presence and severity of aural pressure/tinnitus, hearing loss, unsteadiness, nausea and vomiting in MD patients during remission. Setting: Urban tertiary care referral hospital in a developing country. Methodology: Consecutive patients with diagnosis of Definite Meniere were selected from the Balance and Dizziness Clinic of National Hospital Abuja for the study. Quality of life assessment was carried out using 3 validated tools – Modified MD-POSI, Vertigo Symptom Scale and Tinnitus Handicap Inventory (THI). Patients were included only when they have been vertigo free for at least 4 weeks. Pure tone audiometry was carried out in those with subjective hearing loss at recruitment and 4 weeks later. Results: A total of 26 patients completed the study. All had cinnarizine for acute vertigo control and Betahistine for maintenance of vertigo control. There was female preponderance (17:9). The age range was 32–56 years. The duration of MD ranges from 4 months to 12 years. The total and subscale MD-POSI scores for “between attacks” significantly correlated with hearing, unsteadiness and tinnitus/pressure when compared to during attack. 69.2 per cent of participants experienced symptoms of unsteadiness during remission. 13/26 of participants reported persistent, though less annoying tinnitus that poorly correlated with THI score during remission. Conclusion: Our study showed that significant non-vertigo symptoms affect the quality of life during remission. Perhaps there is need to properly define, in future studies, what constitutes remission in patients with MD.