Meniere’s disease is a complex clinical picture of the inner ear that manifests itself in dizzy spells or vertigo in connection with hearing loss, a feeling of pressure in the ear and ringing or ringing in the ears. About 2.6 million people in Europe and the United States suffer from Meniere’s disease. Find out more about the causes, symptoms, diagnosis and treatment of Meniere’s disease here.
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Meniere’s disease: symptoms and diagnosis Without warning, Konrad G., 42 years old and a teacher by profession, felt severe pressure in the right half of his skull one evening. A little later he got dizzy, he felt that everything was spinning around him, then he started to vomit. Later the dizziness subsided, but he felt pressure in his right ear and a feeling of hearing loss. He went to see his doctor the very next day. The family doctor immediately suspected that a disease of the inner ear was the cause of the symptoms. Menière’s disease, named after the French doctor Prosper Menière (1799-1862), has a negative effect on the sense of balance and actually applied to Konrad G. In many patients, however, the disease is not correctly diagnosed and a long journey through many specialists only leads to the correct diagnosis at a late stage. In industrialized nations, it is estimated that every 1000th person suffers from Meniere’s disease. Especially people between the ages of 40 and 60 are affected by the disease of the inner ear. Every fifth patient has this disease in their family. Too much fluid in the inner ear Meniere’s disease symptoms arise because too much fluid collects in the labyrinth of the inner ear, the part of the inner ear that is responsible for balance and hearing. The cochlea and semicircular canals are located in the inner ear. They are made of bones lined with a soft membrane. A fluid circulates in the cochlea and semicircular canals called endolymph. In the cochlea, movement of the endolymph is triggered by sound waves. This is how sound signals are sent to the brain. The movement of the endolymph in the semicircular canals tells the brain about the position of the body. If there is increased pressure in the inner ear due to too much endolymphatic fluid, its ducts can swell and their function can be restricted as a result. The pressure in the auditory center causes the brain to receive confusing acoustic signals such as noise or ringing (tinnitus) or no signal at all (hearing loss). If the pressure in the balance organ is too high, the brain receives error messages regarding movement and body position – dizziness occurs. The seizures express themselves very differently: They can occur rarely to frequently. And they can last from minutes to several hours. After the attack, those affected are initially exhausted, but mostly symptom-free. Meniere’s disease: causes unknown The exact causes of this inner ear disease are not known. Doctors suspect changes in the metabolism and hormone balance as possible causes, as well as circulatory disorders, stress and mental factors. The development of Meniere’s disease varies from person to person. In over two-thirds of patients, symptoms gradually improve and dizziness decreases over time. In the remaining patients, the vertigo attacks and tinnitus get progressively worse and their hearing ability steadily decreases. Therapy against symptoms Since the cause of Meniere’s disease is unknown, there are many treatments, but no cure. The aim is to reduce the symptoms to a tolerable level and to achieve an improvement as quickly as possible. Doctors prescribe medication to relieve nausea and vomiting, and IV solutions are administered to stimulate blood flow. Treatment of Meniere’s disease: betahistine reduces pressure According to current knowledge, patients with Meniere’s disease particularly benefit from high-dose therapy with the histamine antagonist betahistine. Histamine antagonists are agents that reverse or mitigate the effects of histamine on tissue. Histamines play a major role in the immune system’s defense reactions. Within a year, the vertigo attacks almost completely disappear. Betahistine is also used successfully to prevent attacks over a longer period of time. The active ingredient reduces endolymphatic pressure in the inner ear. The active ingredient should be taken regularly for at least six months, preferably up to 24 months. This Meniere’s disease therapy was well tolerated. Only two patients experienced mild nausea. Meniere’s disease: psychological care is important Meniere’s patients are very insecure as a result of the sudden onset of dizzy spells. Afraid of having a seizure in public, they become withdrawn. The result is loneliness, insecurity and fear. The therapy of attacks of rotary vertigo also includes the treatment and care of the annoying tinnitus, to which the patients are exposed to a more or less pronounced form. In the meantime, treatment concepts have emerged which, although they cannot promise to eliminate the tinnitus, can in most cases achieve the goal, namely the reduction of the psychological and acoustic stress caused by the ringing in the ears. Valuable aids in Meniere’s disease are so-called tinnitus maskers and the use of hearing aids in the case of simultaneous hearing loss.
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