meniere’s disease2

8/3/2019 Menieres Disease2

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Mnire's disease is a condition ofthe inner ear. About 1 in a 1,000 people

develops Mnire's disease. It canaffect anyone at any age, but it mostcommonly begins between the ages of20 and 50. Generally, this condition

starts in one ear only. The other ear isalso affected at some stage in about 4in 10 cases. The disease is named aftera French doctor called Prosper Mnire

who first described the disease in the1860s.


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Causes

The inner ear has fluid-filled

tubes called semicircular canals, orlabyrinths. The canals, along with anerve in your skull, help interpret yourbody's position and maintain yourbalance.

Meniere's disease occurs when a

part of the canal, called theendolymphatic sac, becomes swollen.This sac helps filter and remove fluid inthe semicircular canals.


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The exact cause of Meniere's disease isunknown. It may be related to:

Head injury

Middle ear infectionSyphilis

Other risk factors include:

AllergiesAlcohol use

Fatigue

Recent viral illness

Respiratory infection

Smoking

Stress

Use of certain medications, including aspirin


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Pathophysiology

It may result from overproduction or decreasedabsorption of endolymph- the fluid containedin the labyrinth of the ear. Accumulated

endolymph dilates the semicircular canals,urticle, and saccule and causes degenerationof the vestibular and cochlear hair cells. Overstimulation of the vestibular branch of cranialnerve VIII impairs postural reflexes and

stimulates the vomiting reflex. Perception ofsound is impaired as a result of this excessivecranial nerve stimulation, and injury to sensoryreceptors for hearing may affect auditoryacuity.

This condition may stem from autonomic nervoussystem dysfunction that produces a temporaryconstriction of blood vessels supplying theinner ear. Complications include continued

tinnitus and hearing loss.


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Symptoms

Abnormal sensations of movement (vertigo)

Gets worse with sudden movement

Lasts for a few minutes to several hoursMay come and go

Dizziness

Hearing loss in one or both ears

Low frequency noises lost firstExtent of hearing loss may change

Noises or ringing in the ear (tinnitus)

Sudden episodes of complete disorientation

that causes the person to fall down

Sweating (may be heavy)

Uncontrollable eye movements

Vomiting and nausea
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Exams and Tests

A neurological examination may show problemswith hearing, balance, or eye movement.

A procedure called caloric stimulation tests eyereflexes by warming and cooling the inner earwith water. Abnormal results on this test can be

a sign of Meniere's disease.

Additional tests done to distinguish Meniere'sdisease from other causes of vertigo mayinclude:

Evoked potential studies

Electronystagmography

Head CT scan or head MRI scan

Hearing tests (audiology/audiometry)
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Treatment

There is no known cure for Meniere's disease. The goal of treatment is toreduce pressure in the inner ear and relieve symptoms.

Medications such as antihistamines, anticholinergics, are used but are

rarely effective. Water pills (diuretics) may help relieve fluid pressure in the inner ear. A

low-salt diet to reduce fluid retention may also help

Medicines called antiemetics may be prescribed for nausea and vomiting.Symptoms such as dizziness, and vertigo may respond to sedative/hypnotics

and benzodiazepines such as diazepam. Ear surgery may be required if symptoms are severe and do not respond to

other treatment.

Hearing aids may be needed for severe hearing loss.

Avoid sudden movements that may aggravate symptoms. You may need helpwalking due to loss of balance during attacks.

Avoid bright lights, TV, and reading during attacks, which may makesymptoms worse. Rest during severe episodes, and gradually increaseactivity.

Avoid hazardous activities such as driving, operating heavy machinery,climbing, and similar activities until 1 week after symptoms disappear.
http://www.nlm.nih.gov/medlineplus/ency/article/003093.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003093.htm

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