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Meniere's disease : Causes, Types, Symptoms, Diagnosis and Treatment

 What is Meniere's disease?

Ménière’s disease is a disorder of the sense organ that causes severe lightheadedness (vertigo), ringing within the ears (tinnitus), hearing loss, and a sense of fullness or congestion in the ear. Ménière’s disease sometimes affects just one ear.


Attacks of dizziness could return on suddenly or once a brief amount of symptom or muffled hearing. Some individuals can have single attacks of dizziness separated by long periods of time. Others may experience several attacks nearer along over a variety of days. Some people with Ménière’s disease have vertigo so extreme that they lose their balance and fall. These episodes are referred to as “drop attacks.”


Ménière’s disease will develop at any age, however it seems to happen to adults between forty and sixty years of age. The National Institute on Hearing Disorders and Different Communication Disorders (NIDCD) estimates that some 615,000 people within the US are presently diagnosed with Ménière’s disease, of which 45,500 cases are newly diagnosed every year.

Ménière disease could be a balance disorder. It’s caused by an abnormality partially in the sense organ called the labyrinth. Fluid build-up here can cause a severe spinning sensation (vertigo) and have an effect on the hearing.


What is Meniere's disease

Explanation of medical terms and concept Meniere's disease

Meniere's disease is a disease of the inner ear that can cause dizziness (vertigo) and hearing loss. In most cases, Meniere's disease affects only one ear.

 Meniere's disease can occur at any age but  usually begins in young to middle adulthood. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life. The question is does Meniere's disease go away? And the answer is yes it can Some people find that their Meniere's symptoms eventually dissipate or improve with time and often there is little to no residual effect of the condition after a period of substantial improvement However in some cases such symptoms never fully disappear and minimal improvements may be minor Treatment options are different as well; if you do seek treatment for your Meniere's disease symptoms it will depend on how severe they are 

Symptoms Meniere's disease

The signs of Ménière’s sickness are because of the accumulation of fluid withinside the cubicles of the internal ear, known as the labyrinth. The labyrinth incorporates the organs of stability (the semicircular canals and otolith organs) and of listening to (the cochlea). It has  sections: the bony labyrinth and the membranous labyrinth. The membranous labyrinth is full of a fluid known as endolymph that, withinside the stability organs, stimulates receptors because the frame moves. The receptors then ship alerts to the mind approximately the frame’s function and movement. In the cochlea, fluid is compressed in reaction to sound vibrations, which stimulates sensory cells that ship alerts to the mind. In Ménière’s sickness, the endolymph buildup withinside the labyrinth interferes with the everyday stability and listening to alerts among the internal ear and the mind. This abnormality causes vertigo and different signs of Ménière’s sickness.

Signs and symptoms of Meniere's disease include:

  • Recurring episodes of vertigo. You have a spinning sensation that starts and stops spontaneously. Dizziness attacks occur without warning and usually last from 20 minutes to several hours, but no longer than 24 hours. Severe dizziness can cause nausea. 

  • Hearing loss. Hearing loss in Meniere's disease may come and go, particularly early on. Eventually, most people have some permanent hearing loss.

  • Ringing in the ear (tinnitus). Tinnitus is the perception of a ringing, buzzing, roaring, whistling or hissing sound in your ear.

  • Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the affected ear (full hearing).
    After an episode, signs and symptoms improve and may disappear completely for a time. Over time, the frequency of episodes may decrease. 

When to see a doctor

See your medical doctor when you have symptoms and symptoms or signs of Meniere's disease. These issues may be as a result of different illnesses, and it is vital to get a correct prognosis as quickly as possible. 

Causes Meniere's disease

The cause of Meniere's disease is unknown, but scientists believe it is due to changes in the fluid in  the internal ear canals. Other possible causes include autoimmune diseases, allergies, and genetics.

 The cause of Meniere's disease is unknown. The symptoms of Meniere's disease appear to be the result of an abnormal amount of fluid (endolymph) in the inner ear, but it's not clear what causes this.

 Factors that affect fluid and could contribute to Meniere's disease include:

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

  • Abnormal immune response

  • Viral infection

  • Genetic predisposition

Because no single cause has been identified, it's likely that Meniere's disease results from a combination of factors.

Complications

Unpredictable attacks of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Meniere's disease. An illness can unexpectedly interrupt your life, causing fatigue and stress.

 Dizziness can cause you to lose balance and increase the risk of falls and accidents.

Diagnosis Meniere's disease

If you have symptoms of Meniere's disease, your doctor will order tests to check your balance and hearing, and to rule out other causes of your symptoms.

 Ménière's disease is usually diagnosed and treated by an otolaryngologist (commonly called an otolaryngologist, otorhinolaryngologist). However, there is no definitive test or single symptom that a doctor can use to make a diagnosis.

 Your doctor will conduct an examination and take a medical history. A diagnosis of Meniere's disease requires:

  • Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 hours

  • Hearing loss verified by a hearing test

  • Tinnitus or a feeling of fullness in your ear

  • Exclusion of other known causes of these problems

Hearing assessment

A hearing test (audiometry) evaluates how well you perceive sounds at different pitches and volumes and how well you can distinguish between similar-sounding words. People with Meniere's disease usually have difficulty hearing low frequencies or  high and low frequencies combined with normal hearing in the middle frequencies.

Balance assessment

Balance returns to normal in most people with Meniere's disease between attacks of dizziness. However, you may have some persistent balance issues.

 Tests to assess  inner ear function include:

  • Videonystagmography (VNG). This test assesses balance function by assessing eye movement. Balance sensors in the inner ear are connected to muscles that control eye movement. This connection allows you to move your head while focusing your eyes  on one point. 

  • Rotary-chair testing. Like a VNG, this measures inner ear function based on eye movement. You sit in a computer-controlled rotating chair, which stimulates your inner ear.

  • Vestibular evoked myogenic potentials (VEMP) testing. This test shows promise for not only diagnosing, but also monitoring Meniere's disease. It shows characteristic changes in the affected ears of people with Meniere's disease.

  • Posturography. This computer-based test shows which part of the balance system (vision, inner ear function, or sensations from the skin, muscles, tendons, and joints) you trust the most and which parts can cause problems. While wearing a seatbelt, he stands barefoot on a platform and maintains his balance in various conditions. 

  • Video head impulse test (vHIT). This newer test uses video to measure the eye's responses to sudden movements. As you focus on one point, your head spins quickly and unpredictably. If your eyes move away from the target when you turn your head, you have an abnormal reflex. 

  • Electrocochleography (ECoG). This test examines the inner ear's response to sound. It can help  determine if there is  abnormal fluid buildup  in the inner ear but is not specific to Meniere's disease. 

Tests to rule out other conditions

Blood tests and imaging tests, such as An MRI, for example, can be used to rule out conditions that can cause problems similar to  Meniere's disease, such as: B. a brain tumor  or multiple sclerosis.

Treatment Meniere's disease

Unfortunately, many of the treatments for Meniere's disease have not been extensively studied. The Cochrane Collaboration, which evaluates medical research, found that only two treatments have evidence from clinical trials to support their use. These are:

injections of gentamicin, an antibiotic, into the inner ear to relieve dizziness. This is known as "chemical ablation". The Cochrane researchers said a study showed it works, but it increases the risk of hearing loss.Steroid injections into the inner ear  to fight inflammation. A study showed that this could be effective.

 However, more studies are needed to know how effective both injections are, the researchers concluded.

 Other treatment options that have been studied less  specifically for Meniere's disease include:

 Drugs used to treat dizziness, such as antihistamines, benzodiazepines, and anticholinergics

 Diuretics, which are drugs used to treat fluid retention.

 Surgery to reduce pressure and fluid in the inner ear

 Many other  Meniere's treatment options are suggested, but evidence of their use is lacking.That doesn't necessarily mean they don't work, they just haven't been studied. These treatments include CBD, virtual reality treatment, hyperbaric therapy, acupuncture, and other alternative therapies.

No cure exists for Meniere's disease. A number of treatments can help reduce the severity and frequency of vertigo episodes. But, unfortunately, there aren't any treatments for hearing loss.

Medications for vertigo

Your doctor may prescribe medications to take during a dizzy spell attack to reduce the severity of an attack:

  • Motion sickness medications, such as meclizine or diazepam (Valium), may reduce the spinning sensation and help control nausea and vomiting.

  • Anti-nausea medications, such as promethazine, might control nausea and vomiting during an episode of vertigo.

Long-term medication use

Your doctor might order a medicine to scale back fluid retention (diuretic) and recommend that you just limit your salt intake. For a few people, this mixture helps manage the severity and frequency of Meniere' sickness symptoms.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from other non-invasive procedures and therapies, such as e.g.:

  • Rehabilitation. If you have balance problems between episodes of vertigo, vestibular rehabilitation therapy might improve your balance.

  • Hearing aid. A hearing aid in the ear affected by Meniere's disease can improve your hearing. Your doctor may refer you to an audiologist to discuss what hearing aid options are best for you. 

  • Positive pressure therapy. For difficult-to-treat dizziness, this therapy consists of applying pressure to the middle ear to reduce fluid buildup. A device called a Meniett pulse generator delivers pressure pulses to the ear canal through a breathing tube. The treatment is carried out at home, usually three times a day for five minutes each time.
    Hyperbaric therapy has shown improvement in symptoms of dizziness, tinnitus and ear pressure in some studies but not in others. Its long-term effectiveness has not yet been determined.If the conservative treatments listed above are unsuccessful, your doctor may recommend some of these more aggressive treatments. 

Middle ear injections

Medications injected into the middle ear and then absorbed into the inner ear can improve vertigo symptoms. This treatment is carried out in the doctor's office. Available injections include:

  • Gentamicin, An antibiotic that is toxic to your inner ear will reduce your ear's ability to balance, and your other ear will take over responsibility for balance. However, there is a risk of further hearing loss. 

  • Steroids, such as dexamethasone, also may help control vertigo attacks in some people. Although dexamethasone may be slightly less effective than gentamicin, it's less likely than gentamicin to cause further hearing loss.

Surgery

If vertigo attacks associated with Meniere's disease are severe and debilitating and other treatments don't help, surgery might be an option. Procedures include:

  • Endolymphatic sac procedure. The endolymphatic sac plays a role in regulating the level of fluid in the inner ear. During the procedure, the endolymphatic sac is decompressed, allowing excess fluid levels to drain. In some cases, this procedure is combined with the placement of a shunt, a tube that drains excess fluid from the inner ear. 

  • Labyrinthectomy. In this procedure, the surgeon removes the balance portion of the inner ear, eliminating both the balance and hearing function of the affected ear. This procedure is  only done if you already have near-total or total hearing loss in the affected ear. 

  • Vestibular nerve section. This procedure involves cutting the nerve that connects the balance and motion sensors in the inner ear to the brain (the vestibular nerve). This procedure usually corrects vertigo problems  while trying to preserve hearing in the affected ear. It requires general anesthesia and one night of hospitalization. 

Lifestyle and home remedies

Certain self-care tactics can help reduce the impact of Meniere's disease. Consider these tips for use during an episode:

  • Sit or lie down when you feel dizzy. During a dizzy spell, avoid doing things that can make your signs and symptoms worse, such as sudden movements, bright lights, watching TV, or reading. Try to focus on an object that isn't moving. 

  • Rest during and after attacks. Don't rush to return to your normal activities.

  • Be aware you might lose your balance. A fall can result in serious injury. Use good lighting when you get up at night. If you have chronic balance problems, a walking stick can improve stability.  .

Lifestyle changes

To avoid triggering a vertigo attack, try the following.

  • Limit salt. Consuming foods and drinks high in salt can increase fluid retention. For overall health, try to consume less than 2,300 milligrams of sodium per day. Experts also recommend spreading  salt consumption evenly throughout the day. 

  • Limit caffeine, alcohol and tobacco. These substances can affect the fluid balance in your ears.

Coping and support

Meniere's disease can affect your social life, your productivity and the overall quality of your life. Learn all you can about your condition.

Talk to people who share the condition, possibly in a support group. Group members can provide information, resources, support and coping strategies. Ask your doctor or therapist about groups in your area or look for information from the Vestibular Disorders Association.

Preparing for your appointment

You will likely  see your GP first. Your GP may refer you to an ear, nose and throat (ENT) specialist, a hearing specialist (audiologist) or a specialist in the nervous system  (neurologist).

 Here you will find information on how to prepare for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, e.g. B. Fasting before a test. Make a list of:

  • Your symptoms, especially those you have during an episode, how long they last and how often they occur

  • Key personal information, including major stresses, recent life changes and family medical history

  • All medications, vitamins or supplements you take, including the doses

  • Take a family member or friend along, if possible, to help you remember the information you're given.

  • Questions to ask your doctor

For Meniere's disease, some basic questions to ask your doctor include:

  • What's likely causing my symptoms?

  • What are other possible causes for my symptoms?

  • What tests do I need?

  • Is my condition likely temporary or chronic?

  • What's the best course of action?

  • What are the alternatives to the approach you're suggesting?

  • I have other health conditions. How can I best manage them together?

  • Are there restrictions I need to follow?

  • Should I see a specialist?

  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

  • When did your symptoms begin?

  • How often do your symptoms occur?

  • How severe are your symptoms and how long do they last?

  • What, if anything, seems to trigger your symptoms?

  • What, if anything, seems to improve your symptoms?

  • What, if anything, appears to worsen your symptoms?

  • Have you had ear problems before? Does anyone in your family have a history of inner ear problems?

General summary

Meniere’s is triggered by a number of different things including: Dehydration - Every time we exhale we lose moisture from our bodies If we don’t replenish this moisture with water or other beverages it can irritate the ear and cause dizziness and ringing in your ears As you might imagine this also happens when you have a stuffy nose due to flu or allergies You may find that drinking more water or other beverages throughout the day helps minimize your Meniere's symptoms Hormone changes – Women are much more likely to experience vertigo than men and.

Does drinking water help Meniere's disease?

According to the National Institute of Health poor diet and lifestyle can lead to certain types of ear infections such as swimmer's ear In addition lack of sleep and stress can also contribute to Meniere disease It is unknown why some people develop this condition while others don't so there is no known medical cure for the disorder However doctors use medication to help relieve symptoms.

What vitamins are good for Meniere's disease?

Recommended Vitamins and Supplements to Help Relieve Meniere's Disease Symptoms: Multivitamin- Take a high quality whole food multivitamin such as Garden of Life They may be more expensive but the vitamins are better absorbed because they contain all the necessary components for absorption Suitable for vegetarians and vegans this formula is made without common allergens such as corn wheat soy or yeast To ensure that you get adequate vitamin D3 and B12 ask your physician to test your levels every 6 months If deficient consider taking capsules instead of tablets Capsules can be stored in a dark.

Does chewing gum help vertigo?

Chewing gum like motion sickness bands helps to alleviate the effects of vertigo by stimulating a steady flow of saliva. Saliva has chemicals that can help restore equilibrium.

What can you not do with Meniere's disease?

Meniere's disease is a disorder of the inner ear in which a fluid buildup results in episodes of vertigo deafness and tinnitus In addition to these symptoms you may also experience nausea and vomiting Meniere's disease can occur at any age but most often appears between the ages of 20 and 40. It occurs three times more frequently in women than men The cause of Meniere's disease is unknown although it seems to run in families Medications can help relieve the symptoms by decreasing the amount of fluid produced in the inner ear or dilating blood vessels for an improved blood flow between the chambers of your.

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