Ménière's disease (patient information): Difference between revisions
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'''For the WikiDoc page for this topic, click [[Ménière's disease|here]]''' | '''For the WikiDoc page for this topic, click [[Ménière's disease|here]]''' | ||
{{ | {{Ménière's disease (patient information)}} | ||
'''Editor-in-Chief:''' Alexandra M. Palmer | {{CMG}}; '''Assistant Editor(s)-in-Chief:''' Alexandra M. Palmer | ||
==Overview== | |||
[[Meniere's disease]] is an [[inner ear]] disorder that affects balance and hearing. The disorder usually affects only one ear and is a common cause of [[hearing loss]]. The disease is named after the French physician Prosper Ménière who first described the syndrome in 1861. About 100,000 people a year develop [[Meniere's disease]]. | |||
==What | ==What are the symptoms of Ménière's disease?== | ||
[[ | Symptoms include: | ||
*Abnormal sensations of movement ([[vertigo]]) | |||
*Gets worse with sudden movement | |||
*Lasts for a few minutes to several hours, may come and go | |||
*[[Dizziness]] | |||
*[[Hearing loss]] in one or both ears | |||
*Low frequency noises lost first | |||
*Extent of [[hearing loss]] may change | |||
*Noises or ringing in the ear ([[tinnitus]]) | |||
*Sudden episodes of complete disorientation that causes the person to fall down | |||
*[[Sweating]] (may be heavy) | |||
*Uncontrollable eye movements | |||
*[[Vomiting]] and [[nausea]] | |||
*The feeling of [[dizziness]] and being off balance generally come in attacks that last from minutes to hours. Other [[symptoms]] can last for longer. | |||
The [[symptoms]] of [[Ménière's disease]] occur suddenly and can arise daily or as infrequently as once a year. [[Vertigo]], often the most debilitating [[symptom]] of [[Ménière's disease]], typically involves a whirling [[dizziness]] that forces the sufferer to lie down. [[Vertigo]] attacks can lead to severe [[nausea]], [[vomiting]], and [[sweating]] and often come with little or no warning. | |||
Some individuals with [[Ménière's disease]] have attacks that start with [[tinnitus]] (ear noises), a loss of hearing, or a full feeling or pressure in the affected ear. It is important to remember that all of these [[symptoms]] are unpredictable. Typically, the attack is characterized by a combination of [[vertigo]], [[tinnitus]], and [[hearing loss]] lasting several hours. People experience these discomforts at varying frequencies, durations, and intensities. Some may feel slight [[vertigo]] a few times a year. Others may be occasionally disturbed by intense, uncontrollable [[tinnitus]] while sleeping. [[Ménière's disease]] sufferers may also notice a [[hearing loss]] and feel unsteady all day long for prolonged periods. Other occasional [[symptoms]] of [[Ménière's disease]] include [[headaches]], abdominal discomfort, and [[diarrhea]]. A person's hearing tends to recover between attacks but over time becomes worse. | |||
==What | ==What causes Ménière's disease?== | ||
The symptoms of Ménière's disease | The [[symptoms]] of [[Ménière's disease]] are associated with a change in fluid volume within the fluid-filled tubes of the [[inner ear]]. These tubes are called [[semicircular canals]], or labyrinths, and, along with a [[nerve]] in your skull, help interpret your body's position and maintain your balance. The [[labyrinth]] has two parts: the [[bony labyrinth]] and the [[membranous labyrinth]]. The [[membranous labyrinth]], which is encased by [[bone]], is necessary for hearing and balance and is filled with a fluid called [[endolymph]]. When your head moves, [[endolymph]] moves, causing nerve receptors in the [[membranous labyrinth]] to send signals to the brain about the body's motion. An increase in [[endolymph]], however, can cause the [[membranous labyrinth]] to balloon or dilate, a condition known as endolymphatic hydrops. | ||
[[Meniere's disease]] occurs when a part of the canal, called the [[endolymphatic sac]], becomes swollen. This sac helps filter and remove fluid in the [[semicircular canals]]. | |||
The exact cause of [[Meniere's disease]] is unknown. In some cases, it may be related to: | |||
[[Head injury]] | |||
[[Middle ear]] infection | |||
[[Syphilis]] | |||
Other risk factors include: | |||
*[[Allergies]] | |||
*Alcohol use | |||
*[[Fatigue]] | |||
*Recent viral illness | |||
*Respiratory infection | |||
*Smoking | |||
*[[Stress]] | |||
*Use of certain medications, including [[aspirin]] | |||
[[Genetics]] may also play a role. | |||
Many experts on Ménière's disease think that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph, another inner ear fluid that occupies the space between the membranous labyrinth and the bony inner ear. This mixing, scientists believe, can cause the symptoms of Ménière's disease. Scientists are investigating several possible causes of the disease, including environmental factors, such as noise pollution and viral infections, as well as biological factors. | Many experts on [[Ménière's disease]] think that a rupture of the [[membranous labyrinth]] allows the [[endolymph]] to mix with [[perilymph]], another [[inner ear]] fluid that occupies the space between the [[membranous labyrinth]] and the bony [[inner ear]]. This mixing, scientists believe, can cause the [[symptoms]] of [[Ménière's disease]]. Scientists are investigating several possible causes of the disease, including environmental factors, such as noise pollution and viral infections, as well as biological factors. | ||
==Who is at risk | ==Who is at highest risk?== | ||
Risk factors include: | Risk factors include: | ||
*Allergies | *[[Allergies]] | ||
*Alcohol use | *Alcohol use | ||
*Fatigue | *[[Fatigue]] | ||
*Recent viral illness | *Recent viral illness | ||
*Respiratory infection | *Respiratory infection | ||
*Smoking | *Smoking | ||
*Stress | *[[Stress]] | ||
*Use of certain medications, including aspirin | *Use of certain medications, including [[aspirin]] | ||
== | ==When to seek urgent medical care?== | ||
Call for an appointment with your health care provider if [[symptoms]] of [[Meniere's disease]], such as [[hearing loss]], ringing in the ears, or [[dizziness]], occur or worsen. | |||
==Diagnosis== | |||
Based on a recent study, NIDCD estimates that there are currently approximately 615,000 individuals with diagnosed [[Ménière's disease]] in the United States and 45,500 newly diagnosed cases each year. Proper [[diagnosis]] of [[Ménière's disease]] entails several procedures, including a medical history interview and a [[physical examination]] by a physician, hearing and balance tests, and medical imaging with [[magnetic resonance imaging]] (MRI). Accurate measurement and characterization of [[hearing loss]] are of critical importance in the [[diagnosis]] of [[Ménière's disease]]. | |||
Through the use of several types of hearing tests, physicians can characterize [[hearing loss]] as being sensory, arising from the [[inner ear]], or neural, arising from the hearing nerve. Recording the auditory brain stem response, which measures electrical activity in the hearing nerve and [[brain stem]], is useful in differentiating between these two types of [[hearing loss]]. Electrocochleography, recording the electrical activity of the [[inner ear]] in response to sound, helps confirm the [[diagnosis]]. | |||
To test the vestibular or balance system, physicians irrigate the ears with warm and cool water or air. This procedure, known as caloric testing, results in [[nystagmus]], rapid eye movements that can help a physician analyze a balance disorder. Abnormal results on this test can be a sign of [[Meniere's disease]]. Since [[tumor]] growth can produce [[symptoms]] similar to [[Ménière's disease]], an [[MRI]] is a useful test to determine whether a [[tumor]] is causing the patient's [[vertigo]] and [[hearing loss]]. | |||
Additional tests done to distinguish [[Meniere's disease]] from other causes of [[vertigo]] may include: | |||
*Evoked potential studies | |||
*[[Electronystagmography]] | |||
*Head [[CT scan]] or head [[MRI]] scan | |||
*Hearing tests (audiology/audiometry) | |||
==Treatment options== | ==Treatment options== | ||
There is no cure for Ménière's disease. | There is no cure for [[Ménière's disease]]. The goal of treatment is to reduce pressure in the [[inner ear]] and relieve [[symptoms]]. The [[symptoms]] of the disease are often controlled successfully by reducing the body’s retention of fluids through dietary changes (such as a low-salt or salt-free diet and no [[caffeine]] or alcohol) or medication. Water pills ([[diuretics]]) may help relieve fluid pressure in the inner ear. Changes in medications that either control [[allergies]] or improve blood circulation in the [[inner ear]] may help. Eliminating tobacco use and reducing stress levels are more ways some people can lessen the severity of their [[symptoms]]. | ||
Different surgical procedures have been advocated for patients with persistent, debilitating vertigo from Ménière's disease. Labyrinthectomy (removal of the inner ear sense organ) can effectively control vertigo, but sacrifices hearing and is reserved for patients with nonfunctional hearing in the affected ear. Vestibular neurectomy, selectively severing a nerve from the affected inner ear organ, usually controls the vertigo while preserving hearing, but carries surgical risks. Recently, the administration of the ototoxic antibiotic, gentamycin directly into the middle ear space has gained popularity worldwide for the control of the vertigo of Ménière's disease. | Different surgical procedures have been advocated for patients with persistent, debilitating [[vertigo]] from [[Ménière's disease]]. Labyrinthectomy (removal of the [[inner ear]] sense organ) can effectively control [[vertigo]], but sacrifices hearing and is reserved for patients with nonfunctional hearing in the affected ear. Vestibular neurectomy, selectively severing a nerve from the affected [[inner ear]] organ, usually controls the [[vertigo]] while preserving hearing, but carries surgical risks. Recently, the administration of the ototoxic [[antibiotic]], [[gentamycin]] directly into the [[middle ear]] space has gained popularity worldwide for the control of the [[vertigo]] of [[Ménière's disease]]. | ||
Medications such as [[antihistamines]], [[anticholinergics]], are used but are rarely effective. | |||
Medicines called [[antiemetics]] may be prescribed for [[nausea]] and [[vomiting]]. [[Symptoms]] such as [[dizziness]], and [[vertigo]] may respond to sedative/hypnotics and [[benzodiazepines]] such as [[diazepam]]. | |||
[[Hearing aids]] may be needed for severe [[hearing loss]]. | |||
Avoid sudden movements that may aggravate [[symptoms]]. You may need help walking due to loss of balance during attacks. | |||
Avoid bright lights, TV, and reading during attacks, which may make [[symptoms]] worse. Rest during severe episodes, and gradually increase activity. | |||
Avoid hazardous activities such as driving, operating heavy machinery, climbing, and similar activities until 1 week after [[symptoms]] disappear. | |||
==Diseases with similar symptoms== | ==Diseases with similar symptoms== | ||
*Vertigo | *[[Vertigo]] | ||
*[[Superior canal dehiscence syndrome]] | |||
==Where to find medical care for Ménière's disease== | ==Where to find medical care for Ménière's disease?== | ||
[http://maps.google.com/maps? | [http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Meniere's disease}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Meniere's disease] | ||
==Prevention of Ménière's disease== | ==Prevention of Ménière's disease== | ||
There is no known prevention for Meniere's disease, but prompt treatment of ear infection and other related disorders may be helpful. | There is no known prevention for [[Meniere's disease]], but prompt treatment of [[ear infection]] and other related disorders may be helpful. | ||
==What to expect (Outlook/Prognosis)?== | |||
The outcome varies. [[Meniere's disease]] can often be controlled with treatment. Recovery may occur spontaneously. However, the disorder may be [[chronic]] or disabling. | |||
== | ==Possible complications== | ||
*Inability to walk or function due to uncontrollable vertigo | |||
*Hearing loss on the affected side | |||
==Sources== | ==Sources== | ||
[http://www.nidcd.nih.gov/health/balance/meniere.asp National Institute on Deafness and Other Communication Disorders] | [http://www.nidcd.nih.gov/health/balance/meniere.asp National Institute on Deafness and Other Communication Disorders] | ||
[http://www.nlm.nih.gov/medlineplus/ency/article/000702.htm U.S. National Library of Medicine] | [http://www.nlm.nih.gov/medlineplus/ency/article/000702.htm U.S. National Library of Medicine] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Patient | |||
[[Category:Patient information]] | |||
[[Category:Otolaryngology patient information]] | |||
[[Category:Otolaryngology]] | |||
[[Category:Neurology]] | |||
[[Category:Neurology patient information]] | |||
[[Category:Overview complete]] | |||
[[Category:Template complete]] | |||
[[Category:Disease]] | |||
Latest revision as of 22:02, 9 December 2011
For the WikiDoc page for this topic, click here
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Ménière's disease |
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Ménière's disease On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Alexandra M. Palmer
Overview
Meniere's disease is an inner ear disorder that affects balance and hearing. The disorder usually affects only one ear and is a common cause of hearing loss. The disease is named after the French physician Prosper Ménière who first described the syndrome in 1861. About 100,000 people a year develop Meniere's disease.
What are the symptoms of Ménière's disease?
Symptoms include:
- Abnormal sensations of movement (vertigo)
- Gets worse with sudden movement
- Lasts for a few minutes to several hours, may come and go
- Dizziness
- Hearing loss in one or both ears
- Low frequency noises lost first
- Extent of hearing loss may change
- Noises or ringing in the ear (tinnitus)
- Sudden episodes of complete disorientation that causes the person to fall down
- Sweating (may be heavy)
- Uncontrollable eye movements
- Vomiting and nausea
- The feeling of dizziness and being off balance generally come in attacks that last from minutes to hours. Other symptoms can last for longer.
The symptoms of Ménière's disease occur suddenly and can arise daily or as infrequently as once a year. Vertigo, often the most debilitating symptom of Ménière's disease, typically involves a whirling dizziness that forces the sufferer to lie down. Vertigo attacks can lead to severe nausea, vomiting, and sweating and often come with little or no warning.
Some individuals with Ménière's disease have attacks that start with tinnitus (ear noises), a loss of hearing, or a full feeling or pressure in the affected ear. It is important to remember that all of these symptoms are unpredictable. Typically, the attack is characterized by a combination of vertigo, tinnitus, and hearing loss lasting several hours. People experience these discomforts at varying frequencies, durations, and intensities. Some may feel slight vertigo a few times a year. Others may be occasionally disturbed by intense, uncontrollable tinnitus while sleeping. Ménière's disease sufferers may also notice a hearing loss and feel unsteady all day long for prolonged periods. Other occasional symptoms of Ménière's disease include headaches, abdominal discomfort, and diarrhea. A person's hearing tends to recover between attacks but over time becomes worse.
What causes Ménière's disease?
The symptoms of Ménière's disease are associated with a change in fluid volume within the fluid-filled tubes of the inner ear. These tubes are called semicircular canals, or labyrinths, and, along with a nerve in your skull, help interpret your body's position and maintain your balance. The labyrinth has two parts: the bony labyrinth and the membranous labyrinth. The membranous labyrinth, which is encased by bone, is necessary for hearing and balance and is filled with a fluid called endolymph. When your head moves, endolymph moves, causing nerve receptors in the membranous labyrinth to send signals to the brain about the body's motion. An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate, a condition known as endolymphatic hydrops.
Meniere's disease occurs when a part of the canal, called the endolymphatic sac, becomes swollen. This sac helps filter and remove fluid in the semicircular canals.
The exact cause of Meniere's disease is unknown. In some cases, it may be related to:
Head injury Middle ear infection Syphilis
Other risk factors include:
- Allergies
- Alcohol use
- Fatigue
- Recent viral illness
- Respiratory infection
- Smoking
- Stress
- Use of certain medications, including aspirin
Genetics may also play a role.
Many experts on Ménière's disease think that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph, another inner ear fluid that occupies the space between the membranous labyrinth and the bony inner ear. This mixing, scientists believe, can cause the symptoms of Ménière's disease. Scientists are investigating several possible causes of the disease, including environmental factors, such as noise pollution and viral infections, as well as biological factors.
Who is at highest risk?
Risk factors include:
- Allergies
- Alcohol use
- Fatigue
- Recent viral illness
- Respiratory infection
- Smoking
- Stress
- Use of certain medications, including aspirin
When to seek urgent medical care?
Call for an appointment with your health care provider if symptoms of Meniere's disease, such as hearing loss, ringing in the ears, or dizziness, occur or worsen.
Diagnosis
Based on a recent study, NIDCD estimates that there are currently approximately 615,000 individuals with diagnosed Ménière's disease in the United States and 45,500 newly diagnosed cases each year. Proper diagnosis of Ménière's disease entails several procedures, including a medical history interview and a physical examination by a physician, hearing and balance tests, and medical imaging with magnetic resonance imaging (MRI). Accurate measurement and characterization of hearing loss are of critical importance in the diagnosis of Ménière's disease.
Through the use of several types of hearing tests, physicians can characterize hearing loss as being sensory, arising from the inner ear, or neural, arising from the hearing nerve. Recording the auditory brain stem response, which measures electrical activity in the hearing nerve and brain stem, is useful in differentiating between these two types of hearing loss. Electrocochleography, recording the electrical activity of the inner ear in response to sound, helps confirm the diagnosis.
To test the vestibular or balance system, physicians irrigate the ears with warm and cool water or air. This procedure, known as caloric testing, results in nystagmus, rapid eye movements that can help a physician analyze a balance disorder. Abnormal results on this test can be a sign of Meniere's disease. Since tumor growth can produce symptoms similar to Ménière's disease, an MRI is a useful test to determine whether a tumor is causing the patient's vertigo and hearing loss.
Additional tests done to distinguish Meniere's disease from other causes of vertigo may include:
- Evoked potential studies
- Electronystagmography
- Head CT scan or head MRI scan
- Hearing tests (audiology/audiometry)
Treatment options
There is no cure for Ménière's disease. The goal of treatment is to reduce pressure in the inner ear and relieve symptoms. The symptoms of the disease are often controlled successfully by reducing the body’s retention of fluids through dietary changes (such as a low-salt or salt-free diet and no caffeine or alcohol) or medication. Water pills (diuretics) may help relieve fluid pressure in the inner ear. Changes in medications that either control allergies or improve blood circulation in the inner ear may help. Eliminating tobacco use and reducing stress levels are more ways some people can lessen the severity of their symptoms.
Different surgical procedures have been advocated for patients with persistent, debilitating vertigo from Ménière's disease. Labyrinthectomy (removal of the inner ear sense organ) can effectively control vertigo, but sacrifices hearing and is reserved for patients with nonfunctional hearing in the affected ear. Vestibular neurectomy, selectively severing a nerve from the affected inner ear organ, usually controls the vertigo while preserving hearing, but carries surgical risks. Recently, the administration of the ototoxic antibiotic, gentamycin directly into the middle ear space has gained popularity worldwide for the control of the vertigo of Ménière's disease.
Medications such as antihistamines, anticholinergics, are used but are rarely effective.
Medicines called antiemetics may be prescribed for nausea and vomiting. Symptoms such as dizziness, and vertigo may respond to sedative/hypnotics and benzodiazepines such as diazepam.
Hearing aids may be needed for severe hearing loss.
Avoid sudden movements that may aggravate symptoms. You may need help walking due to loss of balance during attacks.
Avoid bright lights, TV, and reading during attacks, which may make symptoms worse. Rest during severe episodes, and gradually increase activity.
Avoid hazardous activities such as driving, operating heavy machinery, climbing, and similar activities until 1 week after symptoms disappear.
Diseases with similar symptoms
Where to find medical care for Ménière's disease?
Directions to Hospitals Treating Meniere's disease
Prevention of Ménière's disease
There is no known prevention for Meniere's disease, but prompt treatment of ear infection and other related disorders may be helpful.
What to expect (Outlook/Prognosis)?
The outcome varies. Meniere's disease can often be controlled with treatment. Recovery may occur spontaneously. However, the disorder may be chronic or disabling.
Possible complications
- Inability to walk or function due to uncontrollable vertigo
- Hearing loss on the affected side
Sources
National Institute on Deafness and Other Communication Disorders