What is this Meniere’s Disease?
Meniere’s disease is a disease that makes one’s head spin! Yes, the condition is complex, and the main symptom is vertigo or spinning sensation. Diagnosis is complex and needs a detailed history, clinical examination, and tests. The spinning of the head is often accompanied by sudden projectile vomiting, hearing loss, and blocked feeling in the ears.
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What are the Symptoms of Meniere’s disease
Recurrent intractable vertigo, which lasts from 20 minutes to up to 24 hours. It’s disorienting and makes the person bedridden for days. It’s the most distressing symptoms of Meniere’s disease.
Nystagmus associated with vertigo
Nausea and vomiting with the vertigo
Ringing sound in-ear or Tinnitus, which is usually in one ear and is low pitched.
Sensorineural hearing loss, which is fluctuating, gradually increases, usually starts in one ear. It usually involves lower frequencies.
Feeling of pressure in-ear.
Who is affected by Meniere’s disease?
More common in females and often start in the middle ages. The hearing loss and Tinnitus may start in opine ear and later may be bilateral.
Pathophysiologically it’s endolymphatic hydrops. It happens as an independent disease in most cases. But can occur after damage to the inner ear system after mumps, measles, meningitis, syphilis or even head trauma,
How do the Doctor’s test for Meniere’s disease?
It’s a disease affecting the inner ear which houses the delicate system of hearing and balance.
Diagnostic tests
- PTA for hearing loss assessment
- Nystagmography
- Videonystagmography
- Electrocochleography Glycerol dehydration test
- CT brain
- MRI CPA to rule out other conditions
How is Meniere’s Disease treated?
1)Supportive treatment to manage symptoms of vertigo in Meniere’s disease include-
- Intratympanic steroid
- Intratympanic gentamicin
2)Lifestyle changes include-Salt restricted diet and diuretic, restricted coffee, alcohol, tobacco, chocolates, monosodium glutamate(MSG).
3)Counseling and vestibular rehabilitation exercises.
4)Surgical options include endolymphatic decompression and vestibular neurectomy.
In Conclusion:
In my experience in India, the hearing loss and vertigo symptoms respond very well to repeated Intratympanic steroid injections. Recurrence may need a repeated dose, but patients tolerate it well with improvement in vertigo symptoms and also better hearing. The disease is unpredictable. It may have different patterns and severity of the presentation. Surgical treatment is only offered if other modes of treatment don’t give relief from intractable unrelenting vertigo.
Important: If you suffer from Meniere’s disease or vertigo due to any other causes, you must avoid driving.
Have you heard about vertigo?Let me know in the comments below.
