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Ménière's Disease — RACP Adult Medicine MCQ

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EasyNeurologyMénière's DiseaseRACP Adult Medicine

A 25-year-old woman presents with a 3-month history of episodic attacks of vertigo lasting hours, associated with unilateral hearing loss, tinnitus, and aural fullness in the left ear. Audiometry confirms low-frequency sensorineural hearing loss on the left. What is the most likely diagnosis?

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Correct answer: A — Ménière's disease

The episodic nature (hours), unilateral low-frequency hearing loss, tinnitus, and aural fullness constitute the classic tetrad of Ménière's disease. BPPV episodes last seconds; vestibular neuritis causes a single prolonged episode. Vestibular schwannoma causes progressive (not episodic) unilateral hearing loss. Management includes low-salt diet, betahistine, and acute symptom control with prochlorperazine. MRI should be performed to exclude vestibular schwannoma.

Reference: eTG – 2025 – Neurology