What Is Meniere's Disease?
Meniere's disease is an inner-ear disorder that can induce vertigo, a sort of dizziness that makes one feel like they are spinning. The innermost region of your ear is the inner ear. The inner ear has two distinct functions. It converts sound into electrical signals (nerve impulses). The brain can hear and understand sound as a result of this. Balance is also maintained by the inner ear.
It can also produce a ringing sensation in the ears (tinnitus), fluctuating hearing loss, and a sensation of fullness or pressure in the ear. Only one ear is usually impacted, and hearing loss can become permanent over time.
A French doctor, Prosper Meniere, proposed in the year 1860s that the symptoms were caused by the inner ear instead of the brain, as most people thought, and hence the condition was named after him.
What Are the Causes of Meniere's Disease?
The etiology of Meniere's illness is unknown, with no specific explanation for the changes developed due to the disease. Still, scientists believe they do not have a good understanding of how the symptoms develop.
Meniere's disease can be caused by abnormalities in the inner ear's structure or fluid levels. Fluid builds up inside the labyrinth, a portion of the inner ear that houses structures that aid in hearing and balance. The volume, pressure, and chemical composition of the fluid must be correct for all the sensors present in the inner ear to function properly. The additional fluid causes dizziness and hearing issues by interfering with the messages the brain receives.
It is unclear why people develop Meniere's disease. However, scientists have a few suggestions about what might be affecting the fluid in the inner ear:
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Allergic reaction or infection to the inner ear.
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Autoimmune responses by the body.
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Hereditary conditions or family history of the disease.
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Head injury or blow to the head leading to a concussion.
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Migraines.
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Side effects of any medication.
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Drainage issue with the inner ear due to blockage or abnormal structure.
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Alcohol or smoking.
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Tiredness or fatigue.
What Are the Symptoms of Meniere's Disease?
Meniere's disease is a progressive disease, meaning it worsens over time. It may begin slowly, with random hearing loss. Later on, vertigo may appear. People who have Meniere's disease usually experience:
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Ringing and buzzing noises in the ear or tinnitus.
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Dizziness with a sensation of spinning or vertigo.
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Nausea and vomiting.
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Vision can get blurred.
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Feeling a trembling sensation and being unsteady to walk.
These symptoms usually occur simultaneously and can last for minutes or hours, but they usually last two to three hours. The illness normally begins in one ear, although it can eventually extend to both. The symptoms may take a day or two to go away completely. After an episode, you may feel exhausted. The signs and symptoms vary from person to person, although hearing loss without vertigo is unusual. Attacks might occur in clusters or multiple times each week, or they can occur weeks, months, or years apart.
Meniere's disease is most common in adults between the ages of 20 to 60, and it is a rare occurrence in children.
How Is Meniere's Disease Diagnosed?
Meniere's disease cannot be diagnosed with a single test or scan. The doctor will do an interview and physical examination, inquire about the patient's family and medical history, as well as evaluate the signs and symptoms. The doctor will prescribe tests to check the balance and hearing and rule out other possible reasons.
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Audiometry or a hearing test is performed to evaluate whether or not the patient has hearing loss based on their volume (intensity) and the rate at which sound waves vibrates. An audiometer is an electronic device that produces pure tones, the intensity of which can be increased or decreased. Usually, air conduction and bone conduction of sound are measured at varied frequencies. The amount of intensity of sound that has to be raised above the normal level is a measure of the degree of hearing impairment at that frequency. It is charted in the form of an audiogram.
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Electronystagmogram (ENG) or balance tests determine how well the inner ear is working. Meniere's disease patients have a decreased balancing response in one of their ears. Electrodes are placed around your eyes to detect eye movement. It is performed because the inner ear's balancing reaction generates eye movements. Both hot and cold water will be forced into the ear during this test. The water activates the balancing system, and unintentional eye movements will be monitored. Any anomalies in the inner ear can suggest a concern.
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Electrocochleography (ECoG) test measures electrical activity in the inner ear. Hearing loss can be caused by a problem with the inner ear or the ear nerve.
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The auditory brainstem response (ABR) test evaluates the function of the auditory nerves and the brain's hearing center. These tests can inform the doctor whether the issue stems from the inner ear or ear nerve.
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The vestibular-evoked myogenic potential (VEMP) test measures the sound sensitivity of the vestibule, that is, the response to sudden loud noises.
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Posturography testing can assist in figuring out which element of your balancing system is not working properly. This will put your balance to the test and see how well you can maintain it. You will be asked to stand barefoot on a platform that can move in any direction. The doctor will be able to observe how the patient reacts when the platform moves in certain ways while wearing a safety harness.
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Rotary chair testing will show the doctor whether the condition is caused by an ear problem or a brain problem. Since electronystagmogram results can be wrong if one has an ear injury or wax covers one of the ear canals. The eye movements are meticulously recorded while the chair moves in this exam.
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The doctor can request a magnetic resonance imaging (MRI) of the head or a cranial computed tomography (CT) scan to assess any potential brain issues since the symptoms comparable to Meniere's disease can also be caused by brain problems such as multiple sclerosis (MS) or brain tumors.
How to Manage and Treat Meniere's Disease?
Meniere's disease is a chronic ailment that has no known cure. However, a variety of therapies are available to relieve the symptoms, ranging from medicine to surgery in the most difficult situations.
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Medication
Motion sickness medications can help with vertigo, and antiemetic or anti-nausea drugs help with nausea and vomiting. The doctor may prescribe a Diuretic to help reduce the amount of fluid in the body, as Meniere's disease is believed to be caused by a fluid issue in the inner ear.
The doctor may prescribe Gentamicin, an antibiotic that has a slight adverse effect on the inner ear. It disables the damaged ear's function, allowing your "good" ear to take over the balance of the body.
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Physical Therapy
Vertigo symptoms can be improved with vestibular rehabilitation activities. Immediately lie down or sit if one feels dizzy. Do not perform any activity that may induce vertigo. Do not attempt to drive. These exercises aid in the training of the brain to account for the balancing differences between the two ears. A physical therapist can offer a set of exercises to undertake on a regular basis to help with difficulties like imbalance, dizziness, and other problems. Staying active and obtaining exercise, such as walking, might also help.
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Surgery
Surgery could be an option for those who have severe symptoms and have failed to respond to previous therapies. A technique called an endolymphatic sac procedure is used to reduce the fluid production and facilitate fluid outflow in the inner ear. Cochleosacculotomy is a surgical procedure for the development of a fistula between the saccule and the cochlear duct and can help in removing fluid from the ear.
Conclusion:
Meniere's illness is difficult to detect and treat due to its wide spectrum of symptoms. Attacks can be severe or mild, causing worries, anxiety, and hearing loss. Between incidents, there are remission periods. A person suffering from Meniere's illness should seek medical help, as there are numerous ways to treat the symptoms.