scholarly journals Low-dose Oral Methotrexate Management of Patients with Bilateral Ménière's Disease

2000 ◽  
Vol 79 (2) ◽  
pp. 82-92 ◽  
Author(s):  
Jefferson K. Kilpatrick ◽  
Aristides Sismanis ◽  
Robert F. Spencer ◽  
Christopher M. Wise
Keyword(s):  
Low Dose ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Oral Methotrexate ◽  
Immune Mediated ◽  
Dose Oral ◽  
Ménière's Disease

In this retrospective clinical trial, we evaluated the effectiveness of low-dose oral methotrexate in the management of bilateral Ménière's disease of immune-mediated origin. At our tertiary-care referral center, we evaluated ten men and eight women who had longstanding bilateral Ménière's disease that had been unresponsive to traditional conservative medical management. Sixteen of these patients had steroid-responsive bilateral Ménière's disease. Two patients had contraindications to steroids, but their clinical and laboratory evaluations were consistent with an immune-mediated process. Patients were treated with 7.5 to 20 mg/week of oral methotrexate. The mean duration of treatment was 16.7 months (range: 8 to 35), with a mean followup of 2 years (range: 9 mo to 5 yr). Changes in clinical symptoms (vertigo, hearing loss, tinnitus, and aural fullness), audiometric changes, and side effects of therapy were evaluated. Vertigo resolved in 14 patients (78%), was substantially alleviated in three patients (17%), and remained unchanged in one patient (6%). Hearing improved in five patients (28%) and stabilized in seven patients (39%). Tinnitus and aural fullness resolved or was relieved in 11 of 17 (65%) and 13 of 14 (93%) patients, respectively. Side effects were minimal and reversible. We conclude that low-dose oral methotrexate is effective and safe for treating bilateral Ménierè's disease of immune-mediated origin. In this study, methotrexate alleviated vertiginous symptoms and improved or stabilized hearing in most patients. Low-dose methotrexate can be considered for patients with immune-mediated bilateral Meniérè's disease when long-term treatment is required or when a steroid or cyclophosphamide is contraindicated.

scholarly journals UNILATERAL MENIERE’S DISEASE; INTRA TYMPANIC INJECTION OF LOW DOSE GENTAMICIN IN THE TREATMENT

2016 ◽  
Vol 23 (01) ◽  
pp. 93-98
Author(s):  
Prof. Wajahat Bangash ◽  
Dr. Altaf Hussain ◽  
Dr. Muhammad Javed Aslam ◽  
Dr. Atif Sharif ◽  
Dr. Tallat Najeeb
Keyword(s):  
Low Dose ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Streptomycin Treatment for Meniere's Disease

1984 ◽  
Vol 93 (4_suppl) ◽  
pp. 44-48 ◽  
Author(s):  
Herbert Silverstein
Keyword(s):  
Vestibular System ◽  
Low Dose ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Outpatient Basis ◽  
Menière's Disease ◽  
Intratympanic Injection ◽  
Ménière's Disease

This paper describes the author's 10-year experience using streptomycin sulfate in the treatment of Meniere's disease in the following: the classical Schuknecht ablation of the vestibular system in bilateral Meniere's disease (eight patients); the classical Schuknecht ablation of the vestibular system in unilateral Meniere's disease in the only hearing ear (five patients); the intratympanic treatment of unilateral Meniere's disease (four patients); and low dose intramuscular outpatient treatment in unilateral Meniere's disease (five patients). The results of bilateral vestibular ablation were similar to those obtained previously by Schuknecht and others: patients developed profound ataxia with a wide-based gait and oscillopsia, which improved rapidly over a period of months; approximately 30% of patients experienced significant improvement in hearing, which usually deteriorated again after several months; and all patients were relieved of vertigo. Patients with unilateral Meniere's disease in the only hearing ear responded similarly, and hearing was preserved in all cases. Intramuscular streptomycin ablation of the vestibular system is strongly recommended in place of surgery in the only hearing ear in Meniere's disease. Controlled intratympanic injection of streptomycin is not successful as yet because of difficulty in controlling the dose. Low dose subototoxic streptomycin treatment on an outpatient basis offers promise for relief of Meniere's attacks, and may improve hearing in some cases without producing the temporary disabling effects of ataxia and oscillopsia. Streptomycin and similar drugs which may reduce endolymph production may eventually be the treatment of choice for Meniere's disease.

Is low-dose intratympanic gentamicin an effective treatment for Ménière's disease: the Birmingham experience

2015 ◽  
Vol 129 (10) ◽  
pp. 970-973 ◽  
Author(s):  
G J Watson ◽  
C Nelson ◽  
R M Irving
Keyword(s):  
Low Dose ◽  
Symptom Control ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Intratympanic Gentamicin ◽  
Ménière's Disease ◽  
Gentamicin Therapy

AbstractBackground:Since the development of intratympanic aminoglycoside in the 1950s, otologists have been able to chemically ablate the vestibule. We present the results of using low-dose intratympanic gentamicin to treat Ménière's disease.Method:A retrospective review was performed of all patients who underwent low-dose intratympanic gentamicin therapy over seven years. Data on gender, age, number of procedures, pure tone audiometry and symptom control were analysed.Results:In all, 38 patients underwent low-dose intratympanic gentamicin therapy. These comprised 25 females and 13 males, with an average age of 58.4 years. Hearing was preserved in 87.5 per cent of patients, with no significant difference before and after treatment (p = 0.744). In all, 85.7 per cent of patients had complete or substantial symptom control (classes A and B, respectively).Conclusion:Low-dose intratympanic gentamicin therapy was effective in controlling the symptoms of Ménière's disease patients, while preserving hearing.

scholarly journals Current aspects of the treatment of different types of vertigo

2021 ◽  
pp. 91-98
Author(s):  
L. M. Antonenko
Keyword(s):  
Low Dose ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Combination Drug ◽  
Dose Combination ◽  
Ménière's Disease ◽  
Vestibular Neuronitis

Dizziness is one of the most frequent complaints of patients in daily clinical practice. The prevalence of vertigo increases significantly in older patients. In most cases, vertigo is caused by pathology of the peripheral vestibular system: benign paroxysmal positional vertigo, vestibular neuronitis, Meniere’s disease. Episodes of recurrent vestibular vertigo without hearing loss can be associated with vestibular migraine, a diagnosis of which remains low in our country. Modern treatment regimens have been developed for patients with various causes of vertigo and unsteadiness. High effectiveness is achieved with a comprehensive approach to the management of patients with vertigo, which includes vestibular exercises, psychological training, and medications that help to reduce the severity and frequency of vertigo attacks and improve vestibular compensation. Many studies have shown high efficacy of the low-dose combination drug cinnarizine 20 mg + dimenhydrinate 40 mg for the treatment of peripheral and central vertigo, which is well tolerated and does not delay vestibular compensation. The efficacy of the low-dose combination drug cinnarizine + dimenhydrinate and betahistine dihydrochloride was compared in the treatment of patients with unilateral vestibular neuronitis, Meniere’s disease, and other diseases of the peripheral and central vestibular system. Studies have shown no less efficacy of the combined drug cinnarizine + dimenhydrinate in the treatment of Meniere’s disease than of betahistine, a more pronounced improvement in vestibular function in the treatment of vestibular neuronitis with the combined drug than with betahistine. For patients with peripheral vestibulopathy of various etiologies, treatment with the combination drug was more effective than therapy with betahistine.

Sign in / Sign up

Export Citation Format

Share Document