Symptoms and treatment of Menieres
Some medical professionals believe that Menieres disease is caused by an imbalance in the fluid in the inner ear, while others believe it is caused by an autoimmune reaction. In truth, the underlying cause of Menieres disease remains unknown and there is no cure.
Symptoms of Menieres disease include tinnitus (ringing in the ears), hearing loss (typically a low-frequency sensorineural pattern), fullness in the ear and vertigo (specifically rotational vertigo which feels like the world is spinning around the sufferer). Most sufferers present with symptoms in one ear (unilateral), but some cases become bilateral. Tinnitus, hearing loss and fullness in the ear will be fluctuating at first, and then they become constant and permanent. There is no definitive timeline for symptom progression. Some sufferers will progress very quickly from fluctuating symptoms to constant, while others may experience fluctuating symptoms for years.
A Menieres vertigo attack may be preceded by increased tinnitus and fullness in the affected ear. The vertigo, accompanied by nausea and sometimes vomiting, may last from a few minutes to several hours. After the vertigo subsides, patients usually feel exhausted and need to sleep for several hours. Vertigo attacks can occur with little to no warning. This unpredictability can make Menieres disease debilitating. Vertigo attacks are incapacitating, and sufferers with frequent attacks will find their daily activities severely limited. In between vertigo attacks, sufferers may continue to feel unsteady and off-balance.
Vertigo attacks may occur in "clusters" (several happening in a very short time period), followed by a length of "remission" that can last several months or even years. Some believe that Menieres disease will eventually burn itself out, with patients no longer suffering vertigo attacks, although the hearing loss and tinnitus remain. This theory has not been proven.
There is no definitive test for Menieres disease; the diagnosis is one of exclusion. An ear, nose & throat (ENT) doctor should coordinate testing, diagnosis and treatment. Patients exhibiting symptoms of Menieres disease are given an MRI to rule out brain or inner ear tumors, and a blood screening for various infections including Lyme disease, syphilis and assorted antibodies. If all these tests present negative results, a diagnosis of Menieres disease is granted.
There are many suggested treatment options; no one suggestion works for everyone. The focus of any treatment should be to manage the symptoms of Menieres disease. Menieres sufferers are encouraged to limit salt intake, as well as avoid caffeine and alcohol. Medications such as Antivert or Dramamine may be suggested to combat the vertigo. Diuretics are often prescribed as well, to control the salt in the body. Years ago, doctors routinely performed surgery on Menieres patients, but studies found no definitive positive results from these surgeries. Inner ear surgery, while attempting to cure Menieres, destroys any remaining hearing in the affected ear. Another treatment offered by some doctors involves the use of antibiotic injections into the inner ear. This treatment allows the patient to retain some hearing, but like other treatment options, it is not always successful.
Lifestyle can greatly affect a sufferer's symptoms. Avoiding caffeine and alcohol can help limit vertigo attacks, or at least reduce the severity of these attacks. Limiting salt intake can also have positive effects. Lifestyle changes in conjunction with medication can greatly improve the quality of life for many Menieres sufferers.
Menieres disease is a much-misunderstood condition. There is a vast amount of information and support available on the Internet. In addition to gaining knowledge about their condition, sufferers can join online support groups to discuss symptoms, treatment options and disability issues. Sufferers should cautiously read any information they find on the Internet, referring all questions to their physician. Treatment options are always evolving, so sufferers should see their doctor regularly for follow up and management. With adequate care and attention, Menieres sufferers can lead productive and happy lives.
By Ma Picard
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