Risk factors affecting drop attack in patients with Meniere's disease

Area of Science:

• Otolaryngology
• Neurology
• Audiology

Background:

• Drop attacks (DAs) are a debilitating symptom of Meniere's disease (MD).
• The precise risk factors contributing to DAs in MD patients are not fully understood.
• Identifying these predictors is crucial for effective patient management and prognosis.

Purpose of the Study:

• To identify clinical and imaging predictors associated with drop attacks (DAs) in Meniere's disease (MD) patients.
• To explore the relationship between audiometric findings, MRI characteristics, and the occurrence of DAs.

Main Methods:

• A cross-sectional survey of 823 Meniere's disease patients was conducted.
• Data collected included pure tone audiometry (PTA), Gadolinium-contrasted MRI, and patient-reported symptoms.
• Statistical analyses included logistic regression, Kaplan-Meier survival analysis, and Cox regression.

Main Results:

• 15.2% of Meniere's disease patients reported drop attacks.
• Significant risk factors for DAs included affected-side PTA, mild vertigo, and severe difficulty concentrating.
• Vestibular endolymphatic hydrops (EH) alone was not a significant predictor (OR=0.35); mild vertigo increased DA risk 3.4-fold.

Conclusions:

• Affected-side PTA, mild vertigo, and severe concentration difficulties are key risk factors for DAs in MD.
• Endolymphatic hydrops (EH) did not independently predict DAs.
• The timing of DAs varies with vertigo severity, necessitating individualized treatment plans.