Vestibular diuresis in suspected Meniere patients

Diagnosis of Meniere's disease in patients without classical symptoms may present some difficulty. Detection of hydrops in patients with normal or near to normal hearing or presenting unpredictable balance problem with great variability of severity, periodicity and duration is the major concern in reaching the accurate diagnosis to start the therapy as early as possible.

To investigate the diagnostic role of vestibular diuresis, electronystagmographic (ENG) evaluation of 20 patients with "probable" or "possible" Meniere's disease before and after intravenous furosemid administration has been reviewed in a prospective and blinded study and the results have been compared with 20 age-matched control subjects.

Eleven of 20 patients with Meniere's disease (55%) and one of 20 subjects in the control group (5%) demonstrated canal paresis at initial ENG testing. Thirteen patients from Meniere group (65%) and 1 subject from control group (5%) demonstrated positive response to furosemid. Seven of 11 patients with canal paresis in the patient group (63.7%) and 6 of 9 patients with no canal paresis at initial testing demonstrated positive response (66%) to furosemid. No statistical difference between these 2 subgroups was found when compared as response to furosemid. It has been found that there is no clear correlation between the duration of the disease and the positive response to furosemid.

It has been concluded that, although some limitation exists, the sensitivity of furosemid test for evaluation of vestibular function in Meniere's disease is promising as compared with controls.