Ménière's disease
Also Known As: Ménière's disease, Meniere's disease, Endolymphatic hydrops, Cochlear hydrops
Ménière's disease (
/meɪnˈjɛərz/)[1] is a disorder of the inner ear that can affect hearing and balance to a varying degree. It is characterized by episodes of vertigo, low pitched tinnitus, and hearing loss. The hearing loss has a fluctuating then permanent nature, meaning that it comes and goes, alternating between ears for some time, then becomes permanent with no return to normal function. It is named after the French physician Prosper Ménière, who, in an article published in 1861, first reported that vertigo was caused by inner ear disorders. The condition affects people differently; it can range in intensity from being a mild annoyance to a chronic, lifelong disability.[2]
Ménière's often begins with one symptom, and gradually progresses. However, not all symptoms must be present to confirm the diagnosis[3] although several symptoms at once is more conclusive than different symptoms at separate times.[4] Other conditions can present themselves with Ménière's-like symptoms, such as syphilis, Cogan's syndrome, autoimmune disease of the inner ear, dysautonomia, perilymph fistula, multiple sclerosis, acoustic neuroma, and both hypo- and hyperthyroidism.[5]
The symptoms of Ménière's are variable; not all sufferers experience the same symptoms. However, so-called "classic Ménière's" is considered to have the following four symptoms:[6]
- Attacks of rotational vertigo that can be severe, incapacitating, unpredictable, and last anywhere from minutes to hours,[7] but generally no longer than 24 hours. For some, prolonged attacks can occur, lasting from several days to several weeks, often causing the sufferer to be severely incapacitated.[8] This combines with an increase in volume of tinnitus and temporary, albeit significant, hearing loss. Hearing may improve after an attack, but often becomes progressively worse. Nausea, vomiting, and sweating sometimes accompany vertigo, but are symptoms of vertigo, and not of Ménière's.[9]
- Fluctuating, progressive, unilateral (in one ear) or bilateral (in both ears) hearing loss, usually in lower frequencies.[10] For some, sounds can appear tinny or distorted, and patients can experience unusual sensitivity to noises.[11]
- Unilateral or bilateral tinnitus.
- A sensation of fullness or pressure in one or both ears.
Some may have parasitic symptoms, which aren't necessarily symptoms of Ménière's, but rather side effects from other symptoms. These are typically nausea, vomiting, and sweating which are typically symptoms of vertigo, and not of Ménière's. Vertigo may induce nystagmus, or uncontrollable rhythmical and jerky eye movements, usually in the horizontal plane, reflecting the essential role of non-visual balance in coordinating eye movements.[12] Sudden, severe attacks of dizziness or vertigo, known informally as "drop attacks," can cause someone who is standing to suddenly fall.[13] Drop attacks are likely to occur later in the disease, but can occur at any time.[13]
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