Target Health Blog

Meniere's Disease

November 12, 2018


The labyrinth in relation to the ear: The labyrinth is composed of the semicircular canals, the otolithic organs (i.e., utricle and saccule), and the cochlea. Inside their walls (bony labyrinth) are thin, pliable tubes and sacs (membranous labyrinth) filled with endolymph. Credit: NIH/NIDCD

It has been speculated that 1) ___ Darwin suffered from Meniere's disease among other illnesses. Meniere's disease (MD) is a disorder of the inner ear that is characterized by episodes of feeling like the world is spinning, referred to as2) ___. Other symptoms include, ringing in the ears (tinnitus), hearing loss, and a fullness in the ear. Typically, only one ear is affected, at least initially; however, over time both ears may become involved. Episodes generally last from 20 minutes to a few hours. The time between episodes varies. The hearing loss and ringing in the 3) ___ may become constant over time. The cause of Meniere's disease is unclear but likely involves both genetic and environmental factors. A number of theories exist for why it occurs including constrictions in 4) ___ vessels, viral infections, and autoimmune reactions. About 10% of cases run in families. Symptoms are believed to occur as the result of increased fluid build-up in the labyrinth of the inner ear. Diagnosis is based on the symptoms and frequently a hearing 5) ___. Other conditions that may produce similar symptoms include vestibular migraine and transient ischemic attack. There is no known cure. Attacks are often treated with medications to help with the nausea and anxiety. Measures to prevent attacks are overall poorly supported by the evidence. A low salt diet, diuretics, and corticosteroids may be tried. Physical therapy may help with balance and counselling may help with anxiety. Injections into the ear or surgery may also be tried if other measures are not effective but are associated with more 6)___ than benefit. The use of tympanostomy tubes, while popular, is not supported.

Meniere's disease was first identified in the early 1800s by Prosper Meniere. It affects between 0.3 and 1.9 per 1,000 people. It most often starts in people 40 to 60 years old. 7) ____ are more commonly affected than males. After 5 to 15 years of symptoms, the episodes of the world spinning generally stop and the person is left with mild loss of balance, moderately poor hearing in the affected ear, and ringing in their ear. Meniere's is characterized by recurrent episodes of vertigo, hearing loss and tinnitus; episodes may be accompanied by a headache and a feeling of fullness in the ears. People may also experience additional symptoms related to irregular reactions of the autonomic nervous8) ___. These symptoms are not symptoms of Meniere's disease per se, but rather are side effects resulting from failure of the organ of hearing and balance, and include nausea, vomiting, and sweating?which are typically symptoms of vertigo, and not of Meniere's. This includes a sensation of being pushed sharply to the floor from behind. Sudden falls without loss of consciousness (drop attacks) may be experienced by some people.

The cause of Meniere's disease is unclear but likely involves both 9) ___ and environmental factors. A number of theories exist including constrictions in blood vessels, viral infections, autoimmune reactions. The initial triggers of Meniere's disease are not fully understood, with a variety of potential inflammatory causes that lead to endolymphatic hydrops (EH), a distension of the endolymphatic spaces in the inner ear. EH, in turn, is strongly associated with developing Meniere's disease, but not everyone with EH develops Meniere's disease: "The relationship between endolymphatic hydrops and Meniere's disease is not a simple, ideal correlation." Additionally, in fully developed Meniere's disease the balance system (vestibular system) and the hearing system (cochlea) of the inner ear are affected, but there are cases where EH affects only one of the two systems strong enough to cause symptoms. The corresponding subtypes of Meniere's disease are called vestibular Meniere's disease, showing symptoms of vertigo, and cochlear Meniere's disease, showing symptoms of hearing loss and tinnitus. The mechanism of Meniere's disease is not fully explained by EH, but fully developed EH may mechanically and chemically interfere with the sensory cells for balance and hearing, which can lead to temporary dysfunction and even to death of the sensory 10)___, which in turn can cause the typical symptoms of Meniere's disease: vertigo, hearing loss, and tinnitus.

ANSWERS: 1) Charles; 2) vertigo; 3) ears; 4) blood; 5) test; 6) risk; 7) Females; 8) system; 9) genetic; 10) cells

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