MENIERE'S DISEASE
Definition
Meniere's disease is a disorder of the inner ear that affects balance and hearing.
Types
Meniere's disease has three main types:
- Type I: Most common type, characterized by vertigo, tinnitus, and hearing loss.
- Type II: Characterized by vertigo, tinnitus, and normal hearing.
- Type III: Characterized by vertigo, tinnitus, and hearing loss in only one ear.
Aetiology
- The exact cause of Meniere's disease is unknown.
- Fluctuating fluid pressure within the inner ear is believed to be a contributing factor.
- Other contributing factors may include:
- Viral infections
- Trauma to the head or ear
- Genetics
Pathology
- The primary pathology of Meniere's disease involves the endolymphatic sac and the membranous labyrinth of the inner ear.
- Endolymphatic hydrops is the term used to describe the dilatation of the membranous labyrinth.
- The endolymphatic sac is unable to drain excess fluid, leading to a buildup of endolymph in the inner ear.
Pathological changes
- The endolymphatic sac is dilated.
- The membranous labyrinth is distended.
- The cochlea and vestibular system are affected.
- The stria vascularis is thickened.
- The spiral ligament is edematous.
Clinical features
- Vertigo: Spinning sensation that can be severe and disabling.
- Tinnitus: Ringing or other sounds in the ear.
- Hearing loss: Fluctuating hearing loss, especially in the low-frequency range.
- Fullness or pressure: Feeling of fullness or pressure in the ear.
- Nausea and vomiting: May occur during episodes of vertigo.
Investigations
- Clinical examination: Detailed examination of the ear and balance function.
- Tympanometry: Measures the mobility of the eardrum.
- Electrocochleography: Measures the electrical activity of the cochlea.
- Balance testing: Evaluates balance and vestibular function.
- Imaging studies: May be performed to rule out other conditions.
Complications
- Chronic disability: Meniere's disease can lead to chronic disability and a significant impact on quality of life.
- Depression and anxiety: May occur due to the unpredictable nature of the disease.
- Social isolation: May occur due to the stigma associated with the disease.
Management
- Dietary changes: Avoiding caffeine, salt, and sugar may help alleviate symptoms.
- Vestibular rehabilitation therapy: May help improve balance and reduce symptoms.
- Medications: May be prescribed to alleviate symptoms such as vertigo and tinnitus.
- Surgery: May be recommended in severe cases to reduce symptoms and improve quality of life.
Homoeopathic therapeutics
- Arsenicum album: For symptoms of vertigo and hearing loss.
- Kali carbonicum: For symptoms of tinnitus and fullness in the ear.
- Lycopodium clavatum: For symptoms of nausea and vomiting.
- Pulsatilla nigricans: For symptoms of hearing loss and fullness in the ear.
- Sulfur: For symptoms of chronic disability and social isolation.
Important points
- Fluctuating fluid pressure: Is believed to be a contributing factor to Meniere's disease.
- Genetics: May play a role in the development of Meniere's disease.
- Viral infections: May trigger the onset of Meniere's disease.
- Trauma to the head or ear: May contribute to the development of Meniere's disease.