articIes/PM C3098516/"Disease is seen in the age group of 35-60 years. Males are affected more than females"- Dhingra 6th/100"Drop attack: in most instances (64%), the cause of the drop attack is never definitively established. About 12% are due to the heart (a variant of syncope), 8% due to poor circulation to the brain, 8% due to problems with both the heart and brain, 7% due to seizures, 5% due to the inner ear (Menieres disease -- called the otolithic crisis of Tumarkin), and 1%, due to psychological probl emshttp://www. dizziness-and- balance.com/disorders/ central/drop.html"There is marked bulging of Reissner's membrane which may even herniate through the helicotrema into the apical part of sea I a tympani"- Dhingra 5th/111"Hearing improves after the attack & may be norma! during the periods of remission. Some HL is added during every attack. This fluctuating nature of HL is quite characteristic of the disease"- Dhingra 5th/112Menier's Disease (Endolymphatic Hydrop)Meniere's disease is characterized by a tetrad of symptoms of unknown cause: episodic vertigo, fluctuating sensorineural hearing loss; a sensation of aural fullness, and tinnitusThe tinnitus is usually low-pitched and roaring & is aggravated during acute attacks'-'The hearing loss is more severe in the lower frequencies, in many cases progresses over several years, and remains confined to one ear in most patients. The attacks are associated with nausea, vomiting, and prostration. Aural fullness is a manifestation always present in Meniere's attackPathologically, there is generalized dilation of the membranous labyrinth that includes the scala media and endolymphatic sac and is associated with occasional membrane breaks and intermingling of endolymph and perilymph.Circulating immune complexes may be involved in the pathogenesis of Meniere's diseasePatients with severe hydrops should be treated with diuretics, salt restriction, a low-caffeine diet, avoidance of nicotine, and labyrinthine sedatives such as diazepam, 5 mg three times daily, to prevent recurrent attacks.Surgical treatment is currently reserved for patients with severe incapacitating vertigo or tinnitus or to prevent further deterioration of hearing.">