Meniere's Disease: Difference between revisions
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== Associated Co-morbidities == | == Associated Co-morbidities == | ||
Recently, attention has been mainly focused on the immunologic function of the endolymphatic sac; thus, immune disease may contribute to a substantial percentage of Ménière’s disease. Reports of Ménière’s disease associated with thyroid autoimmune disease, allergies and elevated levels of immune complexes and activated lymphocytes suggest an aberrant immune response may be to blame. Other authors have studied the association of viral infection with the development of Ménière’s, but results have been conflicting. Individuals with certain auto immune disorders such as Lupus and severe rheumatoid arthritis, or who suffer from thyroid disorders such as Grave's Disease and Hashimoto's thyroiditis may be at higher risk for developing Ménière’s disease. This sub-group with their potential auto immune cause for the Ménière’s is often treated with cortisone-containing medications, such as Decadron or Prednisone, which slow the immune system's responses. | |||
<br> | <br>It has been suggested that there may be a link between Ménière’s disease and joint disease of the jaw (temporomandibular joint), the cervical spine, Eustachian tube dysfunction, and autonomic nervous system dysfunction.<br> | ||
An increased prevalence of migraine in patients with Menière’s disease (MD) is well documented. Migraine was twice as high in a group of 78 patients with unilateral or bilateral MD (based on the American Academy of Otolaryngology criteria), than in an age- and sex-matched control group (56% vs. 25%, p<0.001). Migraine leads to a greater susceptibility of developing MD, as suggested by a study in which MD patients had an earlier onset of symptoms and a greater frequency of bilateral hearing loss when they also had migraine. | |||
<br>The unpredictable episodes of vertigo are usually the most debilitating problem of Ménière’s disease. Recurrent vertigo often affects patients' daily activities even during periods of remission. The episodes often force a person to lie down for several hours and lose time from work or leisure activities, if they have to climb ladders or operate machinery. Vertigo can increase risk of falls, accidents while driving a car or operating heavy machinery. Sixty percent of Menière's disease patients state that driving was difficult, dangerous or both. These patients may also have permanent hearing loss. As hearing gets progressively worse, the patient may find it more difficult to interact with other people.<br> | |||
Vertigo can also cause emotional stress in patients with Menière's disease. These patients often avoid a wide range of situations and activities for fear of provoking or experiencing a sudden attack. Due to Ménière’s disease's unpredictability, patients with Menière's disease also have depression or anxiety in dealing with the disease. Experts are not sure whether stress/anxiety cause symptoms or whether they are caused by the disease. However, some studies indicate that good stress and anxiety management may help lessen the intensity of symptoms. If your levels of anxiety, stress, and possibly depression are affecting your life, or if you would like to have better control, talk to your doctor. Professional psychotherapy, as well as some medications, has been known to help many patients with Ménière’s disease.<br> | |||
== Systemic Involvement == | == Systemic Involvement == | ||
Revision as of 02:45, 3 April 2012
Original Editors - Mary Glorighian & Mercedes Nelson from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Ménière's disease is a disorder that affects the semicircular canals and cochlea (collectively known as the labyrinth) of the inner ear. These canals help to interpret the bodies position in space and help to maintain balance.
This disorder has an unknown cause but is thought to be due to increased fluid pressure in the inner ear. This can cause episodes of vertigo, tinnitus, fullness in the ear and hearing loss.
Prevalence[edit | edit source]
The prevalence of Ménière’s disease is difficult to assess. It appears that that Menieres disease has a prevalence of about 200 cases/100,000 persons in the United States, or in other words, about 0.2 % of the population has Ménière’s disease. The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s disease and that 45,500 cases are newly diagnosed each year. Ménière’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age. The prevalence of Ménière disease varies in different geographic regions and ethnic groups, but may possibly be lower by as much as a factor of 10 in some populations. Of these, one-third eventually develops the disease in the second ear as well.
There have been several studies of the US population. In a study performed in Framingham, MA, 1.48 % of the population claimed to have a history of Ménière’s disease. This large prevalence figure likely derives from a tendency of many physicians to lump all cases of recurrent vertigo into the category of Ménière’s disease. Mayo Clinic reported prevalence in 1980 in the Rochester, MN population of 218.2 cases/100,000 people, and an incidence rate of new cases of 15.3/100,000 per year. They also reported a diagnosis rate basically proportional to age up to the age of 60, with a decline thereafter. Ménière’s disease in the ears bilaterally was found in 34% of their cohort.
Etiology/Causes [edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
Recently, attention has been mainly focused on the immunologic function of the endolymphatic sac; thus, immune disease may contribute to a substantial percentage of Ménière’s disease. Reports of Ménière’s disease associated with thyroid autoimmune disease, allergies and elevated levels of immune complexes and activated lymphocytes suggest an aberrant immune response may be to blame. Other authors have studied the association of viral infection with the development of Ménière’s, but results have been conflicting. Individuals with certain auto immune disorders such as Lupus and severe rheumatoid arthritis, or who suffer from thyroid disorders such as Grave's Disease and Hashimoto's thyroiditis may be at higher risk for developing Ménière’s disease. This sub-group with their potential auto immune cause for the Ménière’s is often treated with cortisone-containing medications, such as Decadron or Prednisone, which slow the immune system's responses.
It has been suggested that there may be a link between Ménière’s disease and joint disease of the jaw (temporomandibular joint), the cervical spine, Eustachian tube dysfunction, and autonomic nervous system dysfunction.
An increased prevalence of migraine in patients with Menière’s disease (MD) is well documented. Migraine was twice as high in a group of 78 patients with unilateral or bilateral MD (based on the American Academy of Otolaryngology criteria), than in an age- and sex-matched control group (56% vs. 25%, p<0.001). Migraine leads to a greater susceptibility of developing MD, as suggested by a study in which MD patients had an earlier onset of symptoms and a greater frequency of bilateral hearing loss when they also had migraine.
The unpredictable episodes of vertigo are usually the most debilitating problem of Ménière’s disease. Recurrent vertigo often affects patients' daily activities even during periods of remission. The episodes often force a person to lie down for several hours and lose time from work or leisure activities, if they have to climb ladders or operate machinery. Vertigo can increase risk of falls, accidents while driving a car or operating heavy machinery. Sixty percent of Menière's disease patients state that driving was difficult, dangerous or both. These patients may also have permanent hearing loss. As hearing gets progressively worse, the patient may find it more difficult to interact with other people.
Vertigo can also cause emotional stress in patients with Menière's disease. These patients often avoid a wide range of situations and activities for fear of provoking or experiencing a sudden attack. Due to Ménière’s disease's unpredictability, patients with Menière's disease also have depression or anxiety in dealing with the disease. Experts are not sure whether stress/anxiety cause symptoms or whether they are caused by the disease. However, some studies indicate that good stress and anxiety management may help lessen the intensity of symptoms. If your levels of anxiety, stress, and possibly depression are affecting your life, or if you would like to have better control, talk to your doctor. Professional psychotherapy, as well as some medications, has been known to help many patients with Ménière’s disease.
Systemic Involvement[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Medications[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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