## Meniere Disease: Clinical Features and Pathophysiology ### Correct Answer: High-frequency sensorineural hearing loss **Key Point:** Meniere disease characteristically causes **low-frequency sensorineural hearing loss** in the early stages, NOT high-frequency loss. This is a distinguishing feature that helps differentiate it from noise-induced or age-related hearing loss. ### Why the Other Options Are Correct | Feature | Details | |---------|----------| | **Endolymphatic hydrops** | The hallmark pathophysiology—abnormal accumulation of endolymph in the inner ear due to imbalance between production and reabsorption | | **Vertigo duration** | Episodic, spontaneous vertigo lasting 20 minutes to several hours (typically 1–4 hours); NOT brief positional vertigo | | **Prodromal symptoms** | Tinnitus, aural fullness, and hearing fluctuation often precede or accompany vertigo attacks | ### Audiometric Pattern in Meniere Disease **High-Yield:** Early Meniere disease shows **low-frequency sensorineural hearing loss** (500–2000 Hz), which may fluctuate and eventually become permanent. As disease progresses, hearing loss extends to higher frequencies. This low-frequency pattern is pathognomonic and helps distinguish Meniere from: - Noise-induced hearing loss (high-frequency notch) - Age-related presbycusis (bilateral high-frequency loss) - Sudden sensorineural hearing loss (variable pattern) ### Classic Triad of Meniere Disease 1. **Episodic vertigo** (spontaneous, rotatory, severe) 2. **Fluctuating hearing loss** (low-frequency initially) 3. **Tinnitus** (often low-frequency roaring) **Clinical Pearl:** The combination of episodic vertigo with fluctuating low-frequency hearing loss is virtually pathognomonic for Meniere disease. Aural fullness (sensation of pressure in the ear) is a fourth symptom present in ~75% of cases. [cite:Harrison 21e Ch 468]
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.