What is Meniere's disease?
Morbus Meniere is a rare inner ear disorder in which increased pressure in our vestibular organ and inner ear causes seizure-like dizziness, hearing loss and tinnitus. This article clarifies symptoms, causes and treatment.
Morbus Meniere Symptoms
Characteristic of Meniere's disease are attacks of vertigo. They occur suddenly and last for varying lengths of time. The duration varies from 10-20 minutes to several hours. The dizziness is accompanied by nausea, sweating and very often also by a unilateral hearing loss in the low frequency range and a deep tinnitus, which many describe as a "humming". In addition, there is a feeling of pressure on the affected ear.
Not all symptoms occur with every attack. In milder forms, symptoms may occur singly or in various combinations.
The frequency of attacks also varies greatly. Sometimes days, weeks or months pass from one vertigo attack to another. Stress or other illnesses are the determining factors here.
Affected people are in the 50th to 65th year of life. Statistically, women fall ill more often than men.
Morbus Meniere Causes
To understand the causes, it is important to know how our organ of balance works and is structured. First, the vestibular organ consists of three arcuates that are at 90° angles to each other. This allows them to detect all movements in space. The ampullae "utriculus" and "sacculus" or in "large atrial sac" and "small atrial sac" drawn here are also part of the organ of balance. In technical language, the organ of balance is called the "vestibular apparatus."
As can be seen in the picture, the organ of balance and the inner ear, the "cochlea", are connected. Both structures are filled with a viscous fluid called "perilymph."
When the head moves, the fluid moves along in our arcuate ducts. The movement of the fluid ends up in the ampullae, where sensory cells register the movement and transmit it to the brain via nerve pathways. There, the movement is registered.
What happens in Meniere's disease?
What exactly triggers Meniere's disease has not been conclusively clarified to date. What is certain is that too much fluid pressure develops in the vestibular apparatus and inner ear. This is because too much perilymph is produced in Meniere's disease.
On the one hand, this causes the fine sensory hairs in the vestibular organ to kink. Although the head is at rest, the brain receives signals that it interprets as rotation. As a result, a spinning vertigo develops.
On the other hand, the increased pressure ensures that in the inner ear, a fine membrane tears. This membrane (also called Reissner's membrane) separates the different spaces of the inner ear from each other. If perilymph enters the adjacent areas of the inner ear through the rupture, our hair cells are irritated and false alarms occur here as well. As a result, the affected person often hears a tinnitus during an attack, which usually sounds deep and buzzing. The overpressure can also cause the hair cells to malfunction, resulting in a low-pitched hearing loss for the duration of the vertigo attack. This means that low-pitched sounds are heard more poorly.
Initially, as the vertigo subsides, hearing readjusts and the tinnitus subsides.
With increased attacks, the hair sensory cells can be permanently damaged. Long-term disease thus results in persistent hearing loss, which can lead to deafness.
Morbus Meniere diagnosis
To confirm the diagnosis of Meniere's disease, medical professionals can access a number of tests. The examination always begins with a medical history that is as detailed as possible. This is followed by a physical examination and a survey of the ENT status, the Frenzel spectacle examination and a hearing test. The Frenzel glasses are a measuring instrument that magnifies the eyes. The eye is thus examined for eye twitching.
A hearing test is used to determine the hearing threshold, which is the sound at which the patient*s perceives a noise. It is characteristic of Meniere's disease that the patient*s hearing is worse in the low-frequency range.
All this in combination with a buzzing tinnitus helps to make the diagnosis of tinnitus. It is important here to distinguish it from sudden hearing loss, which is usually manifested by a loss of high-frequency hearing and high-frequency tinnitus.
Morbus Meniere therapy
In acute cases, cortisone treatment is started when Meniere's disease is diagnosed. Cortisone helps reduce swelling of the affected structure and provides relief of symptoms.
For long-lasting cases, medications help prevent overpressure in the vestibular organ and inner ear. The dosage here varies greatly from case to case.
For any form of therapy, however, the following applies: a cure by taking medication is not possible. Therapy only combats the symptoms, but not the cause.
Since the prolonged seizures in particular are also psychologically very stressful, many patients benefit from relaxation therapies to better cope with the constant stress.