The possible roles of hormones and enzymes in the production of the acute attack in Menière's disease.

Clinically, the earlier acute vertiginous attacks in Menière's disease and the later deafness appear to constitute a continuum. It is therefore possible that effective treatment of the cause of the acute attacks might prevent the later auditory symptoms. This paper describes biochemical events preceding the acute attacks, and then points to a common factor in the acute and chronic states. If true, this occurrence supports use of intravenous calcium gluconate to abort or cut short an acute attack. Because of the complexities of the situation, it is probable that not every Menière's disease patient will respond to this treatment and a controlled widespread trial is necessary.