What is Meniere's Disease? The French physician Prosper Meniere described a condition which now bears his name. The Meniere's disease symptoms cause episodic vertigo, tinnitus (perception of sound in one or both ears), feeling of pressure or fullness in the ear and fluctuating hearing loss.



A typical attack of Meniere's disease is usually preceded by fullness in one ear. Fluctuation in hearing and changes in the characteristics of tinnitus may also precede an attack. An episode of Meniere generally include: severe vertigo (spinning sensation of the environment), imbalance, nausea and vomiting. The average length of stroke is 2 to 4 hours. There is a marked variability in the duration of Meniere’s disease symptoms.

Some people experience brief episodic "shocks", while others have constant unsteadiness. An unusual sensitivity to visual stimuli is common. During the attack the eyes "jump" (this is called nystagmus). A particularly disabling symptom is the sudden drop to the floor that can occur without warning. This is called "otolithic crisis of Tumarkin," for the original description of Tumarkin (1936).

This is attributed to sudden mechanical deformation of the otolith organs (utricle and saccule), causing rapid activation of vestibular reflexes. Patients feel as if they were suddenly leaning or falling (although they are straight) and try to make re-positioning movements before the crash.

This is a very disabling symptom because it occurs without warning and can cause severe physical damage. Typically, the destructive treatment (eg labyrinthectomy or vestibular nerve section) is the only way to handle this problem. Other otologic conditions may occasionally be associated with Tumarkin falls rate.

Meniere's episodes (attacks) can occur in clusters or in groups (clusters), that is, several attacks may occur in a short period of time. However, several years may pass between episodes. Between attacks most patients are free of symptoms or note slightest imbalance and tinnitus. Meniere's disease affects approximately 0.2% of the population.

Meniere's disease usually starts confined to one ear but usually extends to involve both ears at a time up to 30 years. There are controversies about the statistics, but some authors, eg Silverstein, suggests that the prevalence of bilateral involvement is low, the order of 17% (Silverstein, 1992). We suspect that this low frequency is due to a short follow up of patients and 50% of bilateralism seems more appropriate. Another possibility, however, is the selection bias of patients and different patterns of disease in different countries. Silverstein suggested that 75% of people develop bilateral disease, they will within 5 years.

What causes Meniere's Disease? - It is thought that the attacks in Meniere's disease are due to the fluctuating pressure in the inner ear in these patients. A membrane system, called the membranous labyrinth contains a fluid that is the endolymph. The membranes could begin to expand as a "balloon" when the pressure increases. This is called hydrops. One possible explanation for this is that the drainage system of fluid called endolymphatic duct or sac is blocked.

What can I do to reduce symptoms? Some medications can be prescribed to try to regulate the pressure of fluids in the inner ear, thus reducing the severity and frequency of attacks of Meniere's disease. Dyazide is the most commonly prescribed medication for this purpose. Verapamil (usual dose: 120 SR) sometimes reduces the frequency of attacks. Some doctors report injections of histamine.