active vestibular Meniere's disease

Active Vestibular Meniere's Disease

Meniere's disease is a chronic disorder that affects balance and hearing, causing unpredictable episodes of dizziness and hearing problems. The active phase of the disease is characterized by recurrent bouts of vertigo, which can be severe and debilitating.

• Vertigo: The most common symptom of active vestibular Meniere's disease is vertigo, also known as dizziness or spinning sensation [1]. This can last from a few minutes to several hours and may be accompanied by nausea and vomiting.
• Hearing Loss: Hearing loss is another hallmark of the disease, with affected individuals experiencing fluctuating hearing thresholds in one ear [2].
• Tinnitus: Many people with Meniere's disease experience tinnitus, or ringing in the ears, which can be a constant companion during active episodes [3].
• Ear Pressure: A feeling of fullness or pressure in the affected ear is also common, often accompanied by a sensation of blockage or congestion [4].

During an episode, individuals with Meniere's disease may experience:

• Sudden onset of vertigo
• Hearing loss or fluctuating hearing thresholds
• Tinnitus or ringing in the ears
• Ear pressure or fullness
• Nausea and vomiting

These symptoms can be unpredictable and may occur at any time, making it difficult for individuals with Meniere's disease to plan their daily activities.

References:

[1] Jan 3, 2024 — This chronic disorder affects balance and hearing, causing unpredictable episodes of dizziness and hearing problems. [2] Ménière's disease is a chronic inner ear disorder that leads to recurrent episodes of vertigo, hearing loss and tinnitus. [3] A disorder of the inner ear, which causes intermittent vertigo (dizziness), hearing loss, tinnitus (ear noises), and ear pressure. [4] by T Wright · 2015 · Cited by 85 — Menière's disease causes feelings of fullness or pressure in the ear, hearing loss, tinnitus, and recurrent bouts of vertigo, and mainly affects people aged 30 ...

Common Signs and Symptoms of Active Vestibular Ménière's Disease

Ménière's disease is a chronic disorder that affects the inner ear, causing unpredictable episodes of dizziness and hearing problems. The symptoms can vary widely from person to person, but here are some common signs and symptoms associated with active vestibular Ménière's disease:

• Vertigo: A severe spinning feeling that can cause nausea, vomiting, and unsteadiness [1][2][3]
• Hearing loss: Temporary or permanent hearing loss in one ear, which can vary over time [4][5]
• Tinnitus: Ringing, roaring, or buzzing noises in the affected ear [6][7]
• Ear pressure: A feeling of fullness or pressure in the affected ear [8][9]
• Dizziness: Unpredictable episodes of dizziness or loss of balance [10][11]

These symptoms can occur suddenly and may happen daily, or they may not happen often. In some cases, the symptoms can be severe and debilitating, making it difficult to live a normal life.

References:

[1] Context 1 [2] Context 7 [3] Context 13 [4] Context 2 [5] Context 10 [6] Context 6 [7] Context 15 [8] Context 8 [9] Context 14 [10] Context 11 [11] Context 12

Diagnostic Tests for Active Vestibular Meniere's Disease

Meniere's disease is a chronic inner ear disorder that affects the vestibular system, leading to symptoms such as vertigo, hearing loss, tinnitus, and aural fullness. When diagnosing active vestibular Meniere's disease, several tests can be employed to confirm the condition.

• Electrocochleography (ECog): This test measures the electrical activity of the cochlea and is useful in detecting endolymphatic hydrops, a hallmark of Meniere's disease [2].
• Vestibular-evoked myogenic potential (VEMP) testing: VEMP tests assess the function of the vestibular system by measuring the muscle response to sound stimuli. Abnormal results can indicate vestibular dysfunction, which is common in Meniere's disease [5].
• Electronystagmography (ENG): ENG measures eye movements and can help diagnose vestibular disorders, including Meniere's disease.
• Rotary chair test: This test evaluates the vestibular system by measuring the body's response to rotation. Abnormal results can indicate vestibular dysfunction.
• MRI of internal auditory canals: Magnetic resonance imaging (MRI) can be used to visualize the inner ear structures and detect any abnormalities, such as endolymphatic hydrops.

It is essential to note that these tests are not definitive diagnostic tools for Meniere's disease. A comprehensive diagnosis typically involves a combination of clinical history, hearing tests, and imaging studies [8].

References:

[1] Vestibular Disorders Association. [2] Güneri EA (2016). [3] Jasińska-Nowacka AJ (2024). [4] Kirbac A (2022). [5] Meniere's disease is a chronic, incurable vestibular (inner ear) disorder defined in 1995 by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology—Head and Neck Surgery as “the idiopathic syndrome of endolymphatic hydrops.” [10] [6] Precise genetics in Meniere disease is an area of active research. Vestibular (caloric) function testing may show a significantly under-functioning affected organ in 42% to 74% and a complete loss of function in 6% to 11%. [11] [7] Combined VHIT and caloric testing in Meniere's disease. See also: conflicts between VHIT and rotatory chair testing. Many have recently pointed out that there is a pattern in Meniere's where the VHIT is normal and caloric is reduced. McGarvie et al (2015) discussed that calorics are more sensitive than VHITs to Meniere's. [12] [8] Audiological and vestibular testing plays an important role in diagnosis of Menière’s disease, as disease per se and as staging diagnosis. A battery of tests are recommended in order to have a better evaluation of the disease. Audiological testing includes pure tone audiometry, with highlights of bone conduction especially in acute episodes of Menière’s disease, speech audiometry and... [14]

Medications for Active Vestibular Meniere's Disease

According to medical research, there are several medications that can help manage the symptoms of active vestibular Meniere's disease.

• Vestibular suppressants: A limited course of these medications should be offered to patients for management of vertigo only during Meniere's disease attacks [3].
• Diuretics and/or betahistine: These medications are also recommended for maintenance therapy to reduce symptoms or prevent Meniere's disease attacks [4]. Diuretics can help decrease inner ear fluid volume, while betahistine can help alleviate vertigo symptoms.
• Anti-vertigo medicines: Medications such as betahistine (Serc) and diuretic medicines (water pills) are also used to manage vertigo symptoms in patients with Meniere's disease [5].
• Medications for allergies: In some cases, medications may be given to control allergies that can exacerbate Meniere's disease symptoms [6].

It is essential to note that while these medications can help alleviate symptoms, there is currently no known cure for Meniere's disease. Treatment plans are often tailored to individual patients and may involve a combination of lifestyle changes, medication, and therapy.

References: [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6

Differential Diagnoses for Active Vestibular Meniere's Disease

Active vestibular Meniere's disease can be challenging to diagnose, and several conditions may present with similar symptoms. The following are some differential diagnoses that should be considered:

• Vestibular Migraine: This condition is characterized by episodic vertigo, headache, and other migraine-like symptoms. It is often difficult to distinguish from Meniere's disease, especially in the early stages of diagnosis.
• Recurrent Labyrinthitis: This is an inner ear disorder that can cause recurring episodes of vertigo, hearing loss, and tinnitus. The symptoms may be similar to those experienced by individuals with Meniere's disease.
• Congenital Ear Malformations: Certain congenital conditions, such as microtia or atresia, can lead to vestibular symptoms and hearing loss, which may be mistaken for Meniere's disease.
• Multiple Sclerosis: This autoimmune disorder can cause a range of neurological symptoms, including vertigo and balance problems. In some cases, these symptoms may be similar to those experienced by individuals with Meniere's disease.

Key Points to Consider

When attempting to diagnose active vestibular Meniere's disease, it is essential to consider the following key points:

• Vertigo: The presence of episodic vertigo is a hallmark symptom of Meniere's disease. However, other conditions, such as vestibular migraine and recurrent labyrinthitis, can also cause vertigo.
• Hearing Loss: Hearing loss is another common symptom of Meniere's disease. However, certain congenital ear malformations and multiple sclerosis can also lead to hearing loss.
• Tinnitus: Tinnitus, or ringing in the ears, is a symptom that may be present in individuals with Meniere's disease. However, it can also occur in other conditions, such as vestibular migraine.

References

1. [3] by A Attyé · 2017 · Cited by 51 — The goal of this retrospective study was to investigate the differential diagnosis of endolymphatic hydrops in patients with Meniere's disease (MD) symptoms
2. [4] by T Contributors — Differential Diagnosis[edit | edit source] ; Recurrent labyrinthitis,; Migraine ; Congenital ear malformations,; Multiple sclerosis, ; Posterior fossa arachnoid ...
3. [11] Precise genetics in Meniere disease is an area of active research. ... Differential Diagnosis. Basilar migraine: ... It is essential to base the diagnosis of Meniere disease on the criteria published and mentioned in this article to warrant a uniform diagnosis, especially in the presence of different international approaches to diagnosing ...
4. [14] The differential diagnosis of Meniere’s disease includes otosclerosis, especially the cochlear variant, which may manifest vestibular symptoms in about 25–30% of patients. Acute vestibular labyrinthitis or neuronitis may also mimic the attacks of Meniere’s disease.
5. [15] The diagnosis of Meniere’s disease (MD) and vestibular migraine (VM) is primarily based on clinical criteria and their differentiation is often difficult. Currently, there are no known definitive diagnostic tests that can reliably distinguish the two conditions.