Meniere's Page - Symptons

[Guest guest]

+++Someone was asking about this disease..................++++++++++++

Ménière's disease is usually characterized 4 symptoms.

1) Periodic episodes of rotatory vertigo or dizziness.

2) Fluctuating, progressive, low-frequency hearing loss

3) Tinnitus

4) A sensation of " fullness " or pressure in the ear.

Detailed description of symptoms

1) Periodic episodes of rotatory vertigo or dizziness.

Periodic attacks of vertigo ( the so-called Ménière's " attack " ) is the most

disruptive of the symptoms to the patient. It is usually the vertigo attack

which causes the patient to seek medical treatment. Typically, vertigo occurs

in the form of a series of attacks over a period of weeks or months,

interspersed by periods of remission of variable duration. The attack

consists of a period of dizziness or vertigo (dizziness may include a feeling

of unsteadiness; the term vertigo is normally reserved for the perception of

spinning). The sensation of spinning may produce nystagmus (a beating of the

eyes from side to side), nausea, vomiting, sweating and all the symptoms

normally associated with extreme motion sickness. The onset of vertigo may be

preceeded by a sensation of fullness or pressure in the ear, increased

hearing loss and tinnitus, as described below. The onset is frequently

sudden, reaching peak intensity within minutes and lasting for an hour or

more before subsiding. Unsteadiness may persist for the following hours or

days.

Vertigo must be one of the worst chronic afflictions to affect the body. The

vertigo patient perceives either that the world is spinning around them or

that they themselves are spinning. With many other disabilities, some portion

of a normal life can be continued. Vertigo disrupts virtually every aspect of

life, since the patient loses the ability to do anything normally, especially

when movement is involved. In addition to the obvious hazard of falling,

moving around is hampered by the fact that even small head movements often

make the spinning sensation worse. The resulting nausea, sweating and

vomiting combine to make the patient subjectively very " ill " . Vertigo can

totally incapacitate the individual, so they cannot function. Often the

patient will confine themselves to bed until the symptoms subside.

Most normal individuals probably cannot appreciate the devastating impact of

this condition. Most of us are familiar with mild forms of vertigo or

dizziness (from fair rides, excessive alcohol consumption, etc.). If you

haven't recently experienced vertigo, try the following experiment (in a

large open space, on a soft surface such as grass). Take hold of a heavy

object at arms length (my son recommends a school backpack full of books) and

spin around, leaning slightly backwards to balance the bag. Spin around 10-20

times at a rate of about 2 revolutions /second. Alternatively, if you don't

want to injure yourself by falling over, sit in an " executive " swivel chair

and have someone spin you around as fast as they can without the chair

becoming unstable, for 20-30 seconds. In both these cases, you will

experience rotatory vertigo for a few seconds when you stop rotating. You

will have the sensation you are still spinning, your eyes will exhibit

nystagmus (a beating from side to side) and if you continue, you may

experience nausea. Based on this experience, you now partially understand the

problem. There are additional factors which the patient must deal with. One

is that their vertigo may last from hours to days, compared with the few

seconds you experienced. With the brief episode you experienced, the vertigo

declined quickly with time. For a patient, the vertigo may be sustained, or

even increase in intensity over a few hours. Another difficulty the patient

may have is that the vertigo can be made worse by " external " stimuli, such as

head movements or loud sounds. Even TVs and radios may have to be avoided. It

should also be considered that in this exercise, you had control over your

situation and you knew you could stop when you wanted. You also knew that you

would be fine tomorrow. The Meniere's patient has to deal with a lack of

control of their situation, except for the limited control provided by taking

anti-vertiginous drugs. Even when the symptoms have passed, they must face

the stress and uncertainty of when the next episode will occur, and whether

it will be more or less severe than previous ones. It is generally true that

most people underestimate how disruptive episodic rotatory vertigo can be to

an individual's life.

2) Fluctuating, progressive, low-frequency hearing loss

The hearing loss usually affects one ear, which typically loses sensitivity

to low-frequency (bass) sounds the most. As well as being harder to hear,

sounds may appear " tinny " or distorted. Loud sounds may cause more discomfort

than normal (loudness intolerance). The hearing loss fluctuates over time.

Somtimes the hearing may recover to some extent, but then on other days

hearing may be difficult. In addition, the degree of hearing loss may get

progressively worse with time, eventually affecting all sound frequencies and

hearing may be completely lost in the affected ear.

3) Tinnitus

Tinnitus is sustained, loud " ringing " in the ears. Many normal individuals

experience brief episodes of tinnitus, such as a loud " ping " which declines

over a period of seconds to minutes. The tinnitus experienced by Ménière's

patients is continual and does not abate with time, although its intensity

may vary. The tinnitus is generally nonpulsatile. In addition, it may be

heard more as a load roaring or buzzing sensation, rather than a whistling.

4) Aural fullness

The feeling of " fullness " in the ear is similar to that experienced by

barometric pressure changes (such as when riding up or down a hill, or

ascending or descending in an airplane). However, this fullness cannot

cleared by swallowing, as in the case of pressure changes.

<A HREF= " http://oto.wustl.edu/men/mn1.htm " >Meniere's Page - Symptoms</A>

http://oto.wustl.edu/men/mn1.htm