12
Treatment
Figure 1. CPG: Ménière's Disease Algorithm
KAS1
History and PE
KAS2
NO
Patient with New Episodic Vertigo
YES
2 or More Episodes
20 min–24 hrs
No Other Causes
YES
KAS7
KAS5
Offer Vestibular
Suppressants for Acute
Vertigo
Is migraine
present?
KAS14b
KAS10
KAS3
Out of
Guideline
Obtain Audiogram
Asymmetric
Sensorineural
Hearing Loss
NO
Do Not Order Vestibular
Testing/ECOG to Diagnose
Ménière's Disease
Should Not Offer
Positive Pressure
Therapy
Educate Patient
• About MD
• Diet/Lifestyle
Modification
Should Not Offer
Vestibular Rehab
for Acute Vertigo
KAS6
KAS8
May Offer MRI
KAS4
Migraine and
Suspected
Ménière's
Disease
YES
YES
Migraine Only
