Oral administration of prednisone to control refractory vertigo in Ménière's disease: a pilot study.

OBJECTIVE

To establish whether the oral administration of moderate doses of prednisone reduces refractory vertigo in Ménière's disease.

STUDY

DESIGN

Blinded, randomized, controlled trial.

SETTING

Tertiary referral center.

PATIENTS: Patients with Ménière's disease with limited vertigo control (Class C) and severe disability (Scale 3).

INTERVENTIONS: Two groups (n = 8 per group) were treated orally with either diphenidol (25 mg/d) plus acetazolamide (250 mg/48 h) (control group), or the same treatment plus prednisone (0.35 mg/kg) daily for 18 weeks (prednisone group).

MAIN OUTCOME MEASURES: The variables evaluated were the frequency and duration of vertigo, tinnitus, aural fullness, and audiographic parameters. The clinical surveillance was performed for 12 months after prednisone withdrawal.

RESULTS

The frequency and duration of vertigo episodes were reduced by 50% and 30%, respectively, by prednisone treatment. Prednisone-treated patients manifested a significant reduction in tinnitus. No changes were observed in aural fullness or hearing. No metabolic or infectious disorders were observed.

CONCLUSION

Oral prednisone helps to control refractory vertigo in Ménière's disease. These preliminary data suggest that prednisone can be a good noninvasive antivertigo management regimen for these patients.