Meniere's disease
Ménière’s disease (or syndrome, since its cause its unknown) was first described by French physician Prosper Ménière1861. It isdisorder ofinner ear characterized by vertigo (abnormal sensationmovement),feelingfullness or pressureone or both ears,possibly losshearingtinnitus (noises orsensationringing). Moreover, nausea, vomiting, sweatingnystagmus (uncontrollable rhythmicaljerky eye movements; usuallyhorizontal planeMénière's) may frequently accompany other symptoms. These complaintsfindings occur as episodic bouts, which may last from minuteshoursworsenmovements.The exact causeMénière's diseasenot known, but itbelievedbe caused byswelling ofendolymphatic sac, part ofvestibular system ofinner ear, whichresponsible forbody's sensebalance. The symptoms may occur inpresence ofmiddle ear infection, head trauma or an upper respiratory tract infection, or by using aspirin, smoking cigarettes or drinking alcohol. They may be further exacerbated by excessive consumptioncaffeineeven saltsome patients.
The diagnosisusually established by clinical findingsmedical history. However,detailed neurologic examination, audiometryeven head MRI scan can be performedexcludetumor ofcranial nerve VIII (which would cause similar symptoms).
Treatmentaimed at loweringpressure withininner ear. Antihistamines, anticholinergics, steroids,diuretics may be usedthis purpose. Also,symptoms may be treatedantiemetics (to relieve nausea) or benzodiazepines (which control vertigo directly). Some clinicians may recommendlow salt diet forsame purpose. Surgery ofsemicircular canals orvestibular nervevery rarely performedsome untreatablemost severe cases. Another treatmentchemical labyrinthectomy,whichdrug (such as Gentamycin) that "kills"vestibular apparatusinjected intoinner ear. These radical treatments eliminate vertigo, butalso eliminatepatient's normal sensebalance,soused only aslast resort. The disease may end spontaneouslynever repeat again, recovery may be managed by using medications only,in some limited occasionssymptoms may last despite any kindmedications.
See also: balance disorder
