The famous four symptoms that are essential for diagnosis according to Meniere are: Tinnitus, Vertigo, Hearing loss, Complaints of "Plugged Ears" hydrops. The French Doctor Meniere established the symptomatology in 1861.
The finding of Endolymphatic Hydrops has driven many clinicians to focus on that pathological sign and establish "Hydrops Centered theories and treatments".
Some of the clinicians are are using a different terminology, based on the finding of "Hydrops" and call it: Idiopathic Endolymphatic Hydrops.
Meniere's disease treatment should be given to patients that underwent a comprehensive evaluation of their auditory and vestibular systems by a specialist. The main indication for medications is to relieve symptoms of the disease. Psychotropic medications may help via decreasing the anxiety or depressive symptoms. Drugs that block H2 receptors may relive symptoms of nausea or vomiting. Diuretics may help some of the patients.
Diet with low salt, no alcohol, no caffeine, low sugar and decrease of tobacco may help. Proper management of the Biological Clock may contribute to the relive of some of the symptoms.
The treatment program in this clinic based on clinical studies started in 1981 as a co-production between the Israeli Defence Forces (IDF) and The "Hadassah" university Hospital (Jeruzalem).
The treatment objective is directed towards creating a normal metabolic environment around the nerve cells in the auditory and vestibular systems. Such environment enables the "Curative Mechanisms" to initiate regeneration in a case of mild damage to the neurons.
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The typical course of meniere's disease is attacks of vertigo and tinnitus that come together. Sometimes the vertigo and the tinnitus are co-dominant, in other cases the symptoms are separated by long time intervals.
When the vertigo is the dominant symptom – the patient is almost paralyzed and cannot move by himself. When the tinnitus comes in attacks – the patient may suffer from hearing loss after every attack. In most of the patients the damage is seen in the high frequency part of the audiogram.
When the hearing loss is severe – the patient is suffering from incapacity. The hearing loss may be unilateral (one ear) or bi-lateral (both ears). About 30% of the patients are suffering from Migraine Headache. Between the attacks of vertigo, the patient may experience episodes of Dizziness for few seconds or Imbalance.
There are many theories regarding the causes of Meniere's disease.
Many times it takes years to know that a patient who started with tinnitus – continued with vertigo and hearing loss. Such atypical patients, prevents a good monitoring of the relevant factors at the beginning of their disease.
Viral infection was suspected very frequently, and theories of autoimmune disease or allergy may be considered as a cause or precipitating factors.
Other factors are the same as in tinnitus or vertigo.
On the basis of the 4 symptoms: tinnitus, vertigo, hearing loss and plugged ear, the clinician has to rule out the possibility of other medical conditions. The cause is usually – unknown.
A comprehensive Otto-neurological assessment should be performed in order to rule out tumors, blood vessels abnormality or "canal paresis" in one or more of the semi-circular canals. Audiograms (Hearing test), Imaging (CT, MRI), ENG or Posturography (see: Glossary) may help.
The clinician should check the list of medications that the patient takes for other medical conditions.
Men and women have the same probability of suffering from the disease, typical age range: 20–50 years. About 15 people per 100000 will suffer from Meniere's disease every year. One third will have a chronic course.
* The review of the four medical conditions: tinnitus, vertigo, dizziness and Meniere's disease is not a recommendation for doing tests or taking any therapy. Only an expert who examined the patient can refer a patient for treatment.