3,4 The evaluation process may include the following: Exclusion of other known causes of these sensory problems is also a key factor in properly diagnosing Meniere's. A diagnosis of Meniere’s disease requires two spontaneous episodes of vertigo, each lasting 20 minutes or longer, hearing loss verified by a hearing test on at least one occasion, and tinnitus or aural fullness. Primary care physicians may perform a preliminary evaluation of the condition, and may refer patients to an ear, nose, and throat (ENT) specialist, an audiologist, or a neurologist. No single cause has yet been identified for Meniere’s disease it may be caused by a combination of factors. Improper fluid drainage due to blockage or anatomical abnormality.The following factors may change the properties of inner-ear fluid and cause or trigger Meniere’s disease. 2 This fluid needs to retain a certain volume, pressure, and chemical composition in order for all of the sensors in the inner ear to function properly. The membranous labyrinth contains a fluid hairlike sensors that line the membranous labyrinth respond to movement of the fluid. A membranous labyrinth, made up of a soft structure of membrane, is located inside the bony labyrinth, and is similar in shape. The outer ear consists of bone, and is known as the bony labyrinth. The inner ear consists of a system of connected tubes and cavities called a labyrinth. 1,2 PATHOPHYSIOLOGYĪlthough the etiology of Meniere’s disease is not well understood, it appears to be the result of the abnormal volume or composition of fluid in the inner ear. One should be extremely cautious if vertigo is accompanied by any of the following signs or symptoms: severe headache, double vision, speech impairment, leg or arm weakness, loss of consciousness, numbness or tingling, and chest pain. Vertigo could be a possible sign of other disorders, such as stroke, brain tumor, multiple sclerosis, or diseases of the heart or blood vessels. Nausea and vomiting followed by severe vertigo can happen in some patients.īecause any one of the above problems may be the result of other illnesses, it is important to get an accurate diagnosis as soon as possible. People with Meniere’s disease often feel pain and aural fullness, or increased pressure in the ear. Patients may experience noise in the ear, or tinnitus, the perception of a ringing, buzzing, roaring, or whistling sound. Eventually, most people experience some degree of permanent hearing loss. Hearing loss in Meniere’s disease may fluctuate, particularly early in the course of the disease. Vertigo can also increase the risk of falling of having accidents while driving a car or operating heavy machinery of experiencing depression or anxiety in dealing with the disease and of permanent hearing loss.
The vertigo episodes often force the person to lie down for several hours and lose time from work or leisure activities, and can cause emotional distress. It would feel as if the room were still spinning, and the person would lose balance. Vertigo is a sensation similar to what a person would experience after spinning around quickly and suddenly stopping. Sudden episodes of vertigo are the major symptom of Meniere’s disease these episodes usually last from 20 minutes to 2 hours, but may last up to 24 hours. A person may experience mild vertigo and hearing loss with frequent tinnitus that disturbs sleep, or could have severe episodes of vertigo with few other symptoms. 1 The severity, frequency, and duration of each of these symptoms vary in the early stage of the disease. Episodes often occur in clusters, with long periods of either mild symptoms or no symptoms in between. SIGNS AND SYMPTOMSĮpisodes of Meniere’s symptoms typically last between 20 minutes and 4 hours, after which they improve. This article will review the signs and symptoms, pathophysiology, diagnosis, and current treatment of this disease. Meniere’s disease is considered a chronic condition however, various treatment strategies can help relieve symptoms and minimize the disease’s long-term impact. People between 40 and 50 years of age are most prone to this syndrome, but it can occur in adolescents and children as well. Around 50% of them may go on to develop the disease in both ears. It is estimated that about 90% of people with Meniere’s have the disease in only one ear when first diagnosed. M eniere’s disease is a disorder of the inner ear that causes a sensation of spinning ( vertigo), mild-to-moderate hearing loss, tinnitus, pain, and a feeling of pressure in the ear.
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