Meniere's disease: an overview of information

Ménière's disease (endolymphatic hydrops, endolymphatic edema) is a disease of the inner ear caused by an increase in the amount of endolymph (a dropsy labyrinth) and manifested by periodic attacks of systemic dizziness, noise in the ears, progressive hearing loss by the neurosensory type.

ICD-10 code

H81.0 Ménière's disease.

Epidemiology

According to official figures, the incidence ranges from 8.2 people per 100 000 population in Italy to 157 people per 100,000 population in the UK. The disease suddenly affects people aged 40-50 years, with men and women equally.

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Causes of Meniere's Disease

The disease does not have a definite etiology. The term "idiopathic" takes the first place in the definition of this disease; the main cause (or causes) of this nosological unit depends on a number of factors that can lead to the development of endolymphatic dropsy. Among them - viral infections, vascular disorders, autoimmune processes, allergic reactions, trauma, endocrine diseases, etc.

Ménière's disease - Causes and pathogenesis

[10], [11], [12], [13], [14], [15]

Symptoms of Meniere's Disease

Despite the complete similarity of symptoms, the causes of endolymphatic gypsum in each individual patient may be different. Ménière's disease is rarely seen in childhood, usually a fairly long period of time is required for the development of endolymphatic dropsy. In this case, before the endolymphatic hydrops occur, adverse factors are likely to have multiple or chronic effects on the ear. Despite the fact that both ears are affected by the same factors and pathogenic influences, Meniere's disease usually begins with one side.

Bilateral lesion is observed in about 30% of patients, and as a rule, intracranial hypertension is characteristic. With the development of simultaneous unilateral changes, the endolymphatic hydrops is characterized as secondary.

Ménière's disease - Symptoms

Screening

At the present time, there is no screening method to diagnose Meniere's disease. Dehydration methods and electrochlearography are used to detect the labyrinth hydrops. The examination should include an assessment of the clinical picture and condition of the auditory and vestibular systems, as well as a differential diagnostic complex with diseases of the nervous system, mental disorders, vascular diseases, middle and inner ear diseases that can cause systemic dizziness.

Diagnosis of Ménière's disease

Since the changes in Meniere's disease are localized in the inner ear, the evaluation of the condition of the hearing and balance organ is of the greatest importance in the diagnosis of this disease. When otoscopy is determined by unchanged tympanic membranes. A primary study of auditory function may be performed by an otorhinolaryngologist. In the case of totonotomy, the localization of sounds in the Weber test is determined. With a change in the auditory function, at the early stages, lateralization is determined by the type of neurosensory changes (toward the hearing ear). In tests, Rinne and Federici also identify typical changes in neurosensory hearing loss - both tests are positive both on the side of the hearing ear, and worse than the hearing.

Ménière's Disease - Diagnosis

[16], [17], [18], [19], [20]

Treatment of Meniere's Disease

The peculiarity of conservative treatment of this disease is low evidence of the effectiveness of the treatment, which is associated with a number of factors: the etiology of the disease is not known for certain, there is a high percentage of placebo-positive results of treatment, the severity of pathological symptoms is observed with the course of the disease. The therapeutic measures for Meniere's disease are mostly empirical in nature.

Ménière's disease - Treatment

There are two stages of treatment for Meniere's disease: relief of seizures and long-term treatment.