Named after the French physician Prosper Meniere, Menieres disease is a problem that is associated with the fluid balancing regulating 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 build up in one ear with increasing tinnitus and a drop in hearing. After this happens, the vertigo comes quite suddenly and may last for a few hours to several days. It is only once the vertigo attack is over that the hearing improves.
What are the symptoms associated with Menieres disease?
One of the most weakening symptoms of Menieres disease is vertigo, which can lead to vomiting, severe nausea and sweating. All of these symptoms can come with a little or no warning at all.
Apart from this, some individuals who suffer from Menieres disease have attacks that begin with tinnitus, a loss of hearing or a feeling of fullness or pressure in the affected ear. All these symptoms are experienced at varying frequencies, intensities and durations. Some other symptoms associated with Menieres disease are headache, abdominal discomfort and diarrhea.
How is the diagnosis for Menieres disease made?
To make a diagnosis, the physician will take a history of the duration, frequency, severity and character of your attacks. He/she might also inquire about whether the hearing loss has been changing and if you have had tinnitus or fullness on either of both ears. The physician would also like to know whether you have a history of mumps, syphilis, inflammation of the eyes, an autoimmune disorder or allergy or ear surgery in the past. You might also be questioned about your general health, such as whether you have diabetes, high blood pressure, high blood cholesterol and thyroid or any neurologic or emotional disorders. Once the physician has completed the questioning, he/she will conduct diagnostic tests to check you balance functions and hearing.
The tests may include:
Test for Balance
To test balance the physician may perform Electronystagmograph (ENG). In this procedure, recording electrodes are placed near the eyes in a darkened room. After they have been placed in the above manner, warm and cool air is gently introduced into each ear canal. Using this procedure, the eye movements can be used to test the balance system since the eyes and ears work in coordination through the nervous system. Rotational testing or balance platform may also be used to evaluate the balance system.
Test for Hearing
To test hearing an audiometric examination is used. This test typically indicates a sensory type of hearing loss in the affected ear. If the ear is affected, speech discrimination is often diminished.
Other Tests
Some other tests that may be conducted to make the diagnosis, they are:
- Computer Tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Electrocochleography (ECoG) which is used to indicate increased inner ear fluid pressure in a few cases of Menieres disease
- Auditory brain response (ABR) which is a computerized test used to test the hearing nerves and brain pathway
Sadly there is no cure for Menieres disease, but irrespective of that the symptoms can be controlled successfully by reducing the bodys retention of fluids through dietary changes (which include low-salt or salt-free and no caffeine or alcohol) or medication. Eliminating tobacco and reducing stress levels also help lessen the severity of the symptoms.
Apart for the treatments mentioned above there are different surgical procedures that have been advocated for patients who have persistent, debilitating vertigo from Menieres 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 nonfunctional 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 but also carries risks associated with the surgery.
What should I do when I get an attack?
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 much at this stage. When you feel that the symptoms have gone away, get up slowly. At this time you may want to sleep for several
