Managing drop attacks in patients with Ménière's disease.

OBJECTIVE

Drop attacks are a rare, debilitating symptom of Ménière's disease that affect an individual's physical and mental health. The aim of this series was to assess the response to treatment regimens in patients presenting with drop attacks.

METHODS

A retrospective case series of 8 patients with Ménière's disease and drop attacks was followed up for an average of 67 months (range, 17-120 months).

RESULTS

All patients were initially managed with intratympanic steroids, with four patients having a complete response. The four non-responding patients were treated with intratympanic gentamicin, with one patient responding. Three patients were treated with triple canal occlusion. Two patients demonstrated drop attack resolution and one had a partial response. Seven out of 8 patients (87.5 per cent) suffered from depression.

CONCLUSION

Steroid injections had a 50 per cent success rate in complete resolution of drop attacks. Gentamicin injections and triple semi-circular canal occlusion can bring benefits in patients failing steroid treatment.