Meniere's disease

Clinic

• MD is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear.
• Typically, only one ear is affected initially, but over time, both ears may become involved.
• Episodes generally last from 20 minutes to a few hours. The time between episodes varies.
• The hearing loss and ringing in the ears can become constant over time.

• Causation is unclear, but likely to be constrictions in blood vessels, viral infections, and autoimmune reactions.
• No cure is known

Signs / Symptoms

• Recurrent episodes of vertigo
• Fluctuating hearing loss
• Tinnitus
• Episodes may be preceded by headache / Feeling of fullness in the ears.
• People may also experience additional symptoms related to irregular reactions of the autonomic nervous system.
  • These symptoms are not symptoms of Meniere's disease per se, but rather are side effects resulting from failure of the organ of hearing and balance, and include nausea, vomiting, and sweating, which are typically symptoms of vertigo, and not of Ménière's.
  • This includes a sensation of being pushed sharply to the floor from behind. Sudden falls without loss of consciousness (drop attacks) may be experienced by some people.

Mechanism

• The initial triggers of Ménière's disease are not fully understood, with a variety of potential inflammatory causes that lead to endolymphatic hydrops (EH), a distension of the endolymphatic spaces in the inner ear. EH, in turn, is strongly associated with developing MD, but not everyone with EH develops MD: "The relationship between endolymphatic hydrops and Meniere's disease is not a simple, ideal correlation."
• Additionally, in fully developed MD, the balance system (vestibular system) and the hearing system (cochlea) of the inner ear are affected, but some cases occur where EH affects only one of the two systems enough to cause symptoms. The corresponding subtypes of MD are called vestibular MD, showing symptoms of vertigo, and cochlear MD, showing symptoms of hearing loss and tinnitus.
• The mechanism of MD is not fully explained by EH, but fully developed EH may mechanically and chemically interfere with the sensory cells for balance and hearing, which can lead to temporary dysfunction and even to death of the sensory cells, which in turn can cause the typical symptoms of MD – vertigo, hearing loss, and tinnitus.