Meniere's disease has very unpleasant symptoms: sudden, very violent attacks of vertigo, leading to nausea, vomiting are her trademark. Moreover, Meniere's disease is associated with tinnitus and progressive hearing loss. What are the causes and symptoms, and how is Meniere's disease treated?

Meniere's diseaseis a disease of the inner ear. Severe attacks of vertigo, progressive sensorineural hearing loss, tinnitus, and a feeling of fullness in the ear are characteristic. After many years of the disease, profound sensorineural hearing loss is found in the affected ear. Meniere's disease begins at different ages, but most often it starts around the age of 30-50. It affects men and women equally.

Meniere's disease begins in one ear, but approximately 45 percent of patients develop over time (from several months to several dozen years) in the other ear as well. This is important when deciding on treatment.

Meniere's disease: symptoms

Meniere's disease manifests itself in sudden attacks, usually completely unexpected for the patient. There is no headache during the seizure, but there are:

        • nausea
        • vomiting
        • nystagmus of peripheral origin
        • dizziness
        • vegetative symptoms
        • pale skin
        • wet sweats
        • noise in the ear
        • feeling of crowding in the ear

The patient does not lose consciousness, but contact with him can be very difficult. With each subsequent seizure, sensorineural hearing deteriorates. Consciousness is always maintained and there is no headache, seizures occur with varying frequency. Sometimes the so-calledmeniericus statuswhere seizures last continuously or intermittently for hours or even days.

Meniere's disease: causes

Meniere's disease is an excessive accumulation of fluid in the membranous labyrinth - the labyrinth endolymphatic hydrocele is formed. Most likely it happens as a result of:

  • genetic factors (endogenous Meniere's disease)
  • late consequences of infectious, metabolic and traumatic factors,drug, allergic, rheumatoid, vascular, in the course of certain diseases of the temporal bone and others (extrinsic Meniere's disease)

Meniere's disease: diagnostic tests

Meniere's disease is diagnosed after a detailed examination of the patient, by eliminating other diseases and on the basis of a detailed interview with the patient. The following tests are performed:

  • examination of the hearing organ (tonal audiometry, verbal audiometry, impedance audiometry, brainstem responses audiometry, supra-threshold tests)
  • studies of the equilibrium system (clinical otoneurological examination, videonystagmography, examination of dynamic visual acuity, examination of myogenic atrial evoked potentials, computerized dynamic posturography)
  • imaging tests (computed tomography, magnetic resonance imaging)
  • consultation tests (neurological, ophthalmological)

Meniere's disease: conservative treatment

Conservative treatment in Meniere's disease involves the use of antihistamines that improve blood circulation in the inner ear and brain, anti-vertigo, vascular and calcium channel blockers.

Meniere's disease: post-drum treatment

Sub-drum treatment (transtympanal) consists in injecting corticosteroids or gentamicin directly into the tympanic cavity, hence they penetrate the interior of the labyrinth by diffusion. The injection is made with a very fine needle under local anesthesia.

  • corticosteroids are used in the early stages of the disease, during its exacerbation, to reduce symptoms, improve hearing, reduce the intensity of tinnitus and the feeling of fullness; is a safe method for hearing, but its effectiveness does not exceed 50 percent, due to the practically no complications, it can be used at any stage of the disease, also after surgery
  • gentamicin is used in cases of exacerbation of the disease in patients whose disease has already caused profound hearing loss; the task of gentamicin is to destroy the labyrinth; this method is effective in preventing attacks of vertigo, but carries a risk of up to 30 percent further deterioration of hearing; Moreover, some patients complain of long-lasting imbalances.

Meniere's disease: surgical treatment

Surgical treatment is the most effective way to eliminate vertigo attacks in Meniere's disease. However, it should be remembered that it is only symptomatic treatment, eliminating dizziness, and the disease continues in the labyrinth.

The most effective methodoperative is an operation to cut the vestibular nerve so as to prevent the transmission of information about vertigo from the labyrinth to the brain. This is the only surgical procedure that, with 100% effectiveness in eliminating attacks of vertigo, allows you to preserve your hearing.

Meniere's disease: impact on the patient's life

Meniere's disease, while not fatal, can wreak havoc in the patient's life. The unpredictable nature of Meniere's disease, unexpected severe attacks of vortex vertigo with nausea and vomiting, which cannot be stopped in any way, significantly limit the patient's life. Fear of attacks can completely paralyze the sick person. Moreover, the natural course of the disease includes periods of exacerbation with frequent bouts of dizziness and rapidly progressive hearing loss, and periods of natural remissions that may last for years.

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ENT