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Ménière’s Disease

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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

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