Meniere's Disease

Ménière’s disease is an inner ear disorder that leads to aural fullness, tinnitus, fluctuating hearing loss, and dizziness. Ménière’s disease produces a recurring set of symptoms as a result of abnormally large amounts of a fluid called endolymph collecting in the inner ear. Ménière’s disease can develop at any age, but it is most common in adults between the age of 40 and 60. 

In order to diagnose Meniere’s disease, patients must have a triad of symptoms including: Episodic vertigo lasting 20 minutes to 1 day, tinnitus in the affected ear, fluctuating hearing loss, and recurring episodes of vertigo. The patient may also notice aural fullness in the affected ear. Typically low frequency sensorineural hearing loss is observed in patients with Meniere's disease. Vestibular attacks can occur as frequently as a couple of attacks each week or can be separated by years. The unpredictability of the disorder has made it harder to study, therefore, making it harder to test and diagnose. Meniere’s disease is highly misdiagnosed or overdiagnosed.

Late stage Meniere’s disease refers to a set of symptoms rather than a point in time as every patient progresses differently. Hearing loss, tinnitus, and aural fullness tend to be worse and relatively constant. The vertigo episodes will eventually change to feelings of imbalance, difficulty walking in the dark or on uneven surfaces, and occasional sudden loss of balance. Very rarely patients with late state Meniere's disease will experience a “Tumarkin’s otolithic crisis” that can feel like a sudden drop attack or loss of posture without losing consciousness. 

There are many treatment options on the market currently, but unfortunately no way to cure Meniere’s disease. Treatment options are going to either reduce the severity of an attack while it is occurring, while others attempt to reduce the number of attacks in the long term. Conservative treatment options include: reduced-sodium diet and using a medication that helps control water retention, medications that reduce the severity of vertigo (ex. Valium, lorazepam, etc.), and vestibular rehabilitation therapy which is used to help with the imbalance that can linger between the attacks. More aggressive treatment options include an intratympanic gentamicin injections which will destroy the nerve endings which in turn will damage enough of the balance nerves to stop the vertigo attack, or surgery or to block the movement of information from the affected ear to the brain so that it does not generate balance information.


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