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Ménière’s disease: symptoms, causes, how to cure?

Ménière’s disease is a chronic disease of the inner ear responsible for vertigo and ringing in the ear. It occurs suddenly and most frequently affects women between the ages of 20 and 60. It is exceptional in children and adolescents.

Definition: what is Ménière’s disease?

The Meniere’s disease is a pathology that affects the inner ear, which is the deepest part of the ear. It has a major role in hearing, but also in balance. The origin of the disease can be excessive pressure of the liquid contained in the labyrinth. Other causes could be damage to a nerve, or the central nervous system. Symptoms therefore affect both balance and hearing and occur in seizures. Only one ear is usually affected in Meniere’s syndrome.

Symptoms: what does vertigo look like in Ménière’s disease?

The most common symptom of Ménière’s disease is dizziness, but it is often accompanied by other signs. It is a great rotary vertigo, with balance disordersof sudden onset and which can last several hours, preventing the subject from getting up and walking. It is often accompanied by tinnitus (sounds of varying intensity, heard only by the affected person) or buzzing. Hearing is often impaired in times of crisis. From nausea, vomiting and malaise can frequently occur. This table can be very distressing during the first crisis because it can simulate a stroke. During the following attacks, the subject quickly recognizes his symptoms. the nystagmuswhich corresponds to rapid eye movements in lateral gazes, is a very suggestive sign of Ménière’s disease. A crisis causes great physical and mental exhaustion. Great anxiety about possible recurrence. Between crises balance disorders and tinnitus persist. They are accompanied by anxiety and hearing problems which may be prolonged.

What are the causes of Ménière’s disease?

The causes of Meniere’s disease are not really determined: this disease is caused by a pathology of the inner ear intervening in hearing, posture and balance. Viruses, allergies, immune system abnormalities, or trauma are the most frequently mentioned hypotheses. Sometimes Meniere’s disease occurs in people with an ear infection: this is called Meniere’s syndrome, which disappears when the cause has been treated.

The course of Ménière’s disease is variable. Hearing loss and balance problems may last for several weeks. The frequency of tinnitus varies and its intensity can be severe during attacks. They can persist for a very long time and become intolerable for some people, even causing a serious depressive syndrome.

“Protests can be spectacular and very distressing”

The first crisis of Ménière’s disease must lead to the realization of complementary examinations to be sure of the diagnosis. The manifestations can be spectacular and very distressing. Once the diagnosis has been established, the situations triggering the seizures must be determined and avoided.“, advises Dr. Anne-Christine Della Valle, general practitioner. The diagnosis of Ménière’s disease is simply established by a physical examination, following the description of the symptoms. Some complementary examinations help in the diagnosis such as MRI which, by returning to normal, makes it possible to eliminate another cause, in particular a tumor or a vascular accident. The audiogram, which tests hearing abilities, is often normal at the onset of the disease, and its repetition shows the progressive onset of deafness. A consultation with an ENT specialist is essential during Ménière’s disease.

What are the treatments for Meniere’s disease?

The treatment of Ménière’s disease includes both the treatment of crises and the basic treatment of the disease. In the event of a crisis, quiet rest is necessary. Basic treatment requires psychological supportsometimes supplemented with a drug treatment fighting against anxiety.

Medications

The often associated anxiety can be improved by anxiolytics. Anti-vertigo drugs can be effective. Medication for vomiting is also often needed. When dizziness and vomiting are too severe, intravenous treatment may be necessary to relieve the subject. In the event of an extremely violent crisis, diuretic drugs are sometimes prescribed intravenously Osmotic products such as Mannitol (in the form of an infusion) or Glycerol (orally), can also relieve violent attacks. The use of specialized hearing aids can improve the sensations caused by tinnitus and sometimes even improve hearing.

Diet

A decrease in the consumption of caffeine, alcohol and chocolate, a low-salt diet and a calm life can improve the daily lives of patients.

Relaxation and exercises

Relaxation is also a method that can lessen the effects of tinnitus. In case of inefficiency of the drugs, a vestibular rehabilitation can be proposed. Vestibular exercises make it possible to reinforce certain mechanisms at the origin of the imbalances occurring in Ménière’s disease. More than 30 to 40 annual sessions may be necessary. Different exercises are offered using a rotary chair, specific glasses, a dynamic platform or a trampoline, for example.

Operation

Pressure treatment can be considered when drug treatments or vestibular rehabilitation have not brought any improvement. The placement of a drain, a tube passing through the eardrum, performed under local or general anesthesia, can reduce the intensity and frequency of attacks. Surgical treatment can be offered to people with a severe form of Ménière’s disease despite trying different treatments, but this remains rare.

Can you fly with Ménière’s disease?

Meniere’s disease can have repercussions on daily, personal and professional life and have a significant psychological impact. Psychological support can thus provide considerable help to patients in order to learn to cope with this pathology and to live better with Ménière’s disease. In severe cases, air travel should be limited because variations in barometric pressure can cause seizures.

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