Meniere’s Disease Meniere’s Disease

By: Cindy InfanteBy: Cindy Infante

Psychology (HONORS) Psychology (HONORS)

What is Meniere’s Disease ?What is Meniere’s Disease ?

• Ménière disease is a Ménière disease is a syndrome in which you in which you experience episodes of spinning experience episodes of spinning vertigo (sense of (sense of the room spinning), the room spinning), hearing loss, and , and tinnitus (ringing in the (ringing in the ear). Between the unpredictable ). Between the unpredictable attacks, you usually do not have any problems or attacks, you usually do not have any problems or symptoms of the disease. symptoms of the disease.

Ménière disease was first described in 1861 by the Ménière disease was first described in 1861 by the French physician Prosper Ménière. French physician Prosper Ménière.

Causes Causes • The cause of Meniere's The cause of Meniere's

disease isn't well disease isn't well understood. It appears to understood. It appears to be the result of the be the result of the abnormal volume or abnormal volume or composition of fluid in the composition of fluid in the inner ear. inner ear.

Factors that alter the properties of inner ear fluid Factors that alter the properties of inner ear fluid may help cause Meniere's disease. may help cause Meniere's disease.

• Improper fluid drainage, perhaps because Improper fluid drainage, perhaps because of a blockage or anatomic abnormalityof a blockage or anatomic abnormality

• Abnormal immune responseAbnormal immune response

• AllergiesAllergies

• Viral infectionViral infection

• Genetic predispositionGenetic predisposition

• Head traumaHead trauma

• Migraines Migraines

How is Meniere’s disease How is Meniere’s disease diagnosed?diagnosed?

• Diagnosis is based on a Diagnosis is based on a combination of the right combination of the right set of symptoms set of symptoms (usually episodic (usually episodic dizziness and hearing dizziness and hearing disturbance); hearing disturbance); hearing tests, which document tests, which document that hearing is reduced that hearing is reduced after an attack, and after an attack, and then gets better; and then gets better; and exclusion of alternative exclusion of alternative causes. causes.

Target PopulationTarget Population

• Ménière disease affects Ménière disease affects people of all ages, especially people of all ages, especially those of middle age or older. those of middle age or older. It is, however, uncommon in It is, however, uncommon in children children

• Meniere’s disease affects Meniere’s disease affects roughly 0.2% of the roughly 0.2% of the population. Interestingly, the population. Interestingly, the Framingham study found that Framingham study found that 2% of the population of the 2% of the population of the United States believe they United States believe they have Meniere’s disease, have Meniere’s disease, suggesting that there is suggesting that there is considerable chance of considerable chance of misdiagnosis. misdiagnosis.

Affects with CNS/PNSAffects with CNS/PNS

• An acute attack of Meniere’s disease is An acute attack of Meniere’s disease is generally believed to result from generally believed to result from fluctuating pressure of the fluid within fluctuating pressure of the fluid within the inner ear. This is called “hydrops”. the inner ear. This is called “hydrops”. A system of membranes, called the A system of membranes, called the membranous labyrinth, membranous labyrinth, contains a contains a fluid called fluid called endolymphendolymph. The . The membranes can become dilated like a membranes can become dilated like a balloon when pressure increases. One balloon when pressure increases. One way for this to happen is when the way for this to happen is when the drainage system, called the drainage system, called the endolymphatic ductendolymphatic duct or sac is blocked. or sac is blocked. In some cases, the endolymphatic duct In some cases, the endolymphatic duct may be obstructed by scar tissue, or may be obstructed by scar tissue, or may be narrow from birth. In some may be narrow from birth. In some cases there may be too much fluid cases there may be too much fluid secreted by the secreted by the stria vascularisstria vascularis. . Recently, some have pointed out that Recently, some have pointed out that this “central hypothesis” of Meniere’s this “central hypothesis” of Meniere’s is questionable, as many normal is questionable, as many normal people without Meniere’s have people without Meniere’s have evidence of increased pressure in the evidence of increased pressure in the inner ear too. inner ear too.

SymptomsSymptoms

• Hearing lossHearing loss• Ringing in the ear (tinnitus)Ringing in the ear (tinnitus)• Feeling of fullness in the earFeeling of fullness in the ear• Headache that is unusual or Headache that is unusual or

severe for yousevere for you• Double vision or loss of visionDouble vision or loss of vision• Speech impairmentSpeech impairment• Leg or arm weaknessLeg or arm weakness• Loss of consciousnessLoss of consciousness• Falling or difficulty walkingFalling or difficulty walking• Numbness or tinglingNumbness or tingling• Chest pain Chest pain

Prognosis Prognosis

• Ménière's disease often can Ménière's disease often can find the right combination of find the right combination of lifestyle changes and lifestyle changes and medication to reduce the medication to reduce the frequency and severity of frequency and severity of attacks. Patients with severe, attacks. Patients with severe, disabling symptoms may get disabling symptoms may get relief with surgery, but the relief with surgery, but the risks and benefits need to be risks and benefits need to be weighed carefully. weighed carefully.

Cure / Vaccine or Cure / Vaccine or TreatmentTreatment• No cure exists for Meniere's disease, No cure exists for Meniere's disease,

but a number of strategies may help but a number of strategies may help you manage some symptoms. you manage some symptoms. Research shows that most people with Research shows that most people with Meniere's disease respond to Meniere's disease respond to treatment, although long-term hearing treatment, although long-term hearing loss is difficult to prevent. loss is difficult to prevent.

• Long-term medication useLong-term medication use

• Noninvasive therapies and Noninvasive therapies and proceduresprocedures

• RehabilitationRehabilitation

• Hearing AidHearing Aid• Meniett Device- Meniett Device- For vertigo that's hard to For vertigo that's hard to

treat, this therapy involves the application of positive treat, this therapy involves the application of positive pressure to the middle ear to improve fluid exchange. pressure to the middle ear to improve fluid exchange. A device called a Meniett pulse generator applies A device called a Meniett pulse generator applies pulses of pressure to the ear canal through a pulses of pressure to the ear canal through a ventilation tube. The treatment is performed at home, ventilation tube. The treatment is performed at home, usually three times a day for five minutes at a time. usually three times a day for five minutes at a time.

Notable Case Notable Case

• Alan ShepardAlan Shepard - (November 18, 1923 - - (November 18, 1923 - July 21, 1998) was the first American July 21, 1998) was the first American in space and the fifth person to walk in space and the fifth person to walk on the moon, commanding the Apollo on the moon, commanding the Apollo 14 mission. In the early 1964 Shepard 14 mission. In the early 1964 Shepard was diagnosed with Meniere's Disease. was diagnosed with Meniere's Disease. The condition caused him to be The condition caused him to be removed from flight status for most of removed from flight status for most of the 1960's as the disease cause the 1960's as the disease cause disorientation, disorientation, dizziness and nausea. . In 1963 Shepard was designated Chief In 1963 Shepard was designated Chief of the Astronaut office which involved of the Astronaut office which involved monitoring the coordination, schedule, monitoring the coordination, schedule, and control of all activities involving and control of all activities involving the NASA astronauts. Shepard was the NASA astronauts. Shepard was eventually restored to full flight status eventually restored to full flight status by 1969 after going through corrective by 1969 after going through corrective surgery. At the age of 47 years old, he surgery. At the age of 47 years old, he was the oldest astronaut in the was the oldest astronaut in the program when he took part in his program when he took part in his second space flight as commander of second space flight as commander of the Apollo 14.the Apollo 14.

Celebrities with Meniere Celebrities with Meniere Disease Disease • Emily Dickinson - poet Emily Dickinson - poet

born 1830's born 1830's

• Peggy Lee - singer 1920 – Peggy Lee - singer 1920 – 20022002

Organizations and Facilities Organizations and Facilities

• Vestibular Disorders Association

• RSS Feeds

• Directory of Organizations (Deafness and Communication Disorders)

Citations Citations

• http://american-hearing.org/disorders/menieres-disease/http://american-hearing.org/disorders/menieres-disease/#diagnosed#diagnosed

• http://www.menieresinfo.com/http://www.menieresinfo.com/

• Meniere's diseaseMeniere's disease - MayoClinic.com - MayoClinic.com