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Meniere's Disease
Posted on Jun 17, 2016
Named after the French physician Prosper Meniere, Meniere's disease is a problem that is associated with the fluid balancing system in the inner ear. Generally, it is defined as the symptom complex of episodic vertigo (sensation of whirling and spinning), tinnitus (ringing, roaring, and hissing that usually occurs in one ear), aural pressure (feeling of pressure in the concerned ear), and fluctuating hearing loss. There is a pattern involved here, which is usually a sensation of pressure building up in one ear with increasing tinnitus and a drop in hearing. After this happens, the vertigo comes quite suddenly, which may last for a few hours to several days. When the vertigo attack is over the hearing improves.

Causes of Meniere's disease

There exists a portion in the inner ear known as the labyrinth, within which, fluid is contained. The labyrinth has two parts: the membranous labyrinth and the bony labyrinth. The membranous labyrinth, required for hearing and balance, is encased by bone, and filled with a fluid called endolymph. When we move our heads, the endolymph fluid moves causing nerve receptors in the membranous labyrinth to send signals to the brain about the body's motion. An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate. This condition is known as endolymphatic hydrops.

Perilymph is another fluid that occupies the space between the membranous labyrinth and the bony inner ear. It is the belief of many experts that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph. Accordingly, this results in the symptoms of Meniere's disease. Nonetheless, the exact cause of this condition remains unknown. In some cases, a connection exists between the onset of the illness and recently suffered head injury, middle ear infection, or syphilis. Other factors that increase the risk, include, allergies, alcoholism, fatigue, recent viral illness, respiratory infection, smoking, stress, and use of certain medications like aspirin. Genetics also play a role in acquiring this disease.
The symptoms of Meniere's disease vary from person to person, they are not definite. The two main symptoms are vertigo and tinnitus, which are described below in detail.
  • Vertigo: The patient experiences severe attacks of vertigo, a feeling of falling, which can also cause spinning of the head and imbalance. The person feels as if he is flying or floating in air. These symptoms can disrupt all the other aspects of life. This attack can last for minutes or for hours together. It may be followed by nausea, or even vomiting. The patient is advised to sleep in such cases, as head movements or any external sound can make vertigo grow worse.
  • Tinnitus: Another main symptom is the ringing or booming sensation in one or both ears, also known as tinnitus. Sometimes, there is also a feeling of fullness in the ear, which is accompanied by a feeling of pressure. There is a strong sensitivity of visual stimuli, followed by nystagmus which is involuntary movements of eyeballs or jumping of eyes. Sometimes, the attack is followed by vomiting, excessive sweating, and nausea. The disease and its disability may include temporary or permanent hearing loss in one or both ears. Feeling of exhaustion and sleepiness can be observed after the attack is over.

If you are experiencing the symptoms like vertigo or tinnitus to some extent, don't jump to the conclusion that you are suffering from Meniere's disease. A proper diagnosis is necessary several tests are carried out, like Magnetic Resonance Imaging (MRI) or Electroencephalogram (EEG). They can help to confirm the disease. Along with this, several hearing tests like audiometry are also performed for diagnosing this disorder.
Unfortunately, there is no cure, however, the symptoms can be controlled successfully by reducing the body's retention of fluids through dietary changes (which include low-salt or salt-free food and no caffeine or alcohol) or medication. Eliminating tobacco and reducing stress levels also help lessen the severity of the symptoms.

Apart from the treatment options mentioned above, there are various surgical procedures that have been advocated for patients, who have persistent, debilitating vertigo from Meniere's disease. One such surgical treatment is Labyrinthectomy, in which the inner ear sense organ is removed. This procedure can control vertigo, but is reserved for patients, who have non-functional hearing in the affected ear. Vestibular neurectomy is another such treatment, in which, a nerve from the affected ear is selectively severed. This procedure usually controls vertigo while preserving the hearing however, it also carries certain surgical risks.

During an attack, it is advisable to lie flat on a surface keeping your eyes aimed at an object that is stationary. Do not eat or drink anything. When you feel that the symptoms have gone away, get up slowly. At this time you may want to sleep for several hours. Remember to call your doctor, if you keep vomiting for more than 24 hours, and are not able to keep down any liquids.
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