active cochleovestibular Meniere's disease

Active Cochleovestibular Meniere's Disease

Meniere's disease is a severe inner ear condition characterized by debilitating symptoms, including spontaneous vertigo, fluctuating and progressive hearing loss, tinnitus (ear noises), and aural fullness or pressure within the affected ear [3]. The active cochleovestibular form of the disease refers to its impact on the inner ear's cochlear and vestibular systems.

Symptoms:

• Spontaneous vertigo (dizziness) [4]
• Fluctuating and progressive hearing loss [5]
• Tinnitus (ringing in the ears) [6]
• Aural fullness or pressure within the affected ear [7]

These symptoms can be unpredictable and episodic, causing significant distress for those affected. The disease's underlying mechanisms remain largely elusive today, despite being first described by Prosper Meniere in the 1860s [3].

Genetic Component:

Meniere's disease is a polygenic disorder, with ten percent of cases in patients of European descent having familial Meniere disease [10]. The condition may show autosomal dominant or recessive inheritance but is most commonly sporadic. Precise genetics in Meniere disease is an area of active research.

Impact on Daily Life:

Meniere's disease can have a significant impact on daily life, affecting balance and hearing. Unpredictable episodes of dizziness and hearing problems can make everyday activities challenging [7]. It is essential for those affected to seek medical attention to manage their symptoms and prevent further complications.

References: [3] - Meniere's disease (MD) is a severe inner ear condition known by debilitating symptoms, including spontaneous vertigo, fluctuating and progressive hearing loss, tinnitus, and aural fullness or pressure within the affected ear. [4] - A disorder of the inner ear, which causes intermittent vertigo (dizziness), hearing loss, tinnitus (ear noises), and ear pressure. [5] - by TA Fife · 2014 · Cited by 38 — ... symptoms. Ménière's disease (MD) is characterized by cochleovestibular dysfunction that manifests as fluctuating sensorineural hearing loss ... [6] - Ménière's disease is characterized by fluctuating low-frequency hearing loss and tinnitus, episodic vertigo, and a sensation of fullness or pressure in the ... [7] - Jan 3, 2024 — This chronic disorder affects balance and hearing, causing unpredictable episodes of dizziness and hearing problems. [10] - Genetic component: Meniere disease is a polygenic disorder. Ten percent of cases in patients of European descent have familial Meniere disease. The condition may show autosomal dominant or recessive inheritance but is most commonly sporadic. Precise genetics in Meniere disease is an area of active research.

Common Signs and Symptoms of Active Cochleovestibular Meniere's Disease

Meniere's disease is a disorder of the inner ear that affects balance and hearing, causing unpredictable episodes of dizziness and hearing problems. The three typical symptoms of Meniere's disease are:

• Varying degrees of hearing loss: This can range from mild to severe and may be temporary or permanent [5].
• Tinnitus: A ringing, buzzing, or other type of noise in the ear that can be constant or intermittent [3][7].
• Dizziness (vertigo): Episodes of dizziness that can last from a few minutes to several hours, making it difficult to balance and walk [1][5].

Other symptoms may include:

• Aural fullness: A feeling of pressure or blockage in the ear [3].
• Subjective tinnitus: Tinnitus that is perceived only by the individual experiencing it [2].
• Progressive loss of hearing: Gradual decline in hearing ability over time [8].

These symptoms can vary widely from person to person and may be triggered by factors such as stress, fatigue, or changes in weather. In some cases, Meniere's disease can also cause a sensation of fullness or pressure in the ear, making it difficult to concentrate or perform daily activities.

References:

[1] Context result 4 [2] Context result 5 [3] Context result 3 [5] Context result 5 [7] Context result 7 [8] Context result 8

Diagnostic Tests for Active Cochleovestibular Meniere's Disease

Meniere's disease is a disorder of the inner ear that affects balance and hearing. When symptoms are present, several diagnostic tests can help confirm the diagnosis.

• Hearing Test: A hearing specialist called an audiologist performs a series of tests to check for any changes in hearing related to the disease in the middle ear or other causes.
• Balance Test: This may include an electronystagmogram (ENG), rotational testing, or balance platform testing to assess the reflex of the inner ear (vestibular) balance system and eye muscles.
• MRI: A magnetic resonance imaging scan is done to rule out any tumors or lesions in the inner ear or central nervous system.
• Electrocochleography (ECOG): This test measures electrical activity of the cochlea, which can help diagnose Meniere's disease.

Additional Tests

Other tests that may be recommended include:

• Caloric Test: A caloric test is used to make a diagnosis in cases where symptoms suggest Meniere's disease.
• Audiogram and MRI: An audiogram and an MRI (with gadolinium enhancement) of the central nervous system are also recommended to confirm the diagnosis.

Diagnostic Criteria

For a definitive diagnosis, two or more spontaneous episodes of vertigo lasting 20 minutes to 12 hours must be present, along with hearing loss in one or both ears for low to medium frequency sounds, documented by a hearing test before, during, or after one of the episodes of vertigo.

These diagnostic tests and criteria can help confirm a diagnosis of active cochleovestibular Meniere's disease.

Medications for Active Cochleovestibular Meniere's Disease

Meniere's disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. While there is no cure for Meniere's disease, various medications can help manage its symptoms.

Standard Pharmacological Treatments

The standard pharmacological treatments for active cochleovestibular Meniere's disease include:

• Anti-vertigo drugs: These medications, such as antihistamines and anticholinergics, can help reduce the severity of vertigo attacks [2].
• Diuretics: Diuretics may be prescribed to prevent or lessen the severity of vertigo attacks due to Meniere's disease [3].
• Vestibular suppressants: Medications like meclizine (Antivert) and dimenhydrinate (Dramamine) can reduce the sensation of spinning and provide relief from nausea and vomiting [10].

Other Medications

In addition to these standard treatments, other medications may be prescribed to manage symptoms:

• Betahistine: This medication is often used in Europe to treat Meniere's disease and vertigo [12].
• Prochlorperazine: Also known as Stemetil, this anti-sickness drug can help relieve the symptoms of nausea, vomiting, and vertigo associated with Meniere's disease [14].

Important Note

It's essential to note that while these medications can help manage symptoms, they do not cure Meniere's disease. Ablative therapy is a second-line treatment approach for Meniere disease, which involves using gentamicin or other medications to reduce vertigo attacks [8].

Differential Diagnosis of Active Cochleovestibular Meniere's Disease

Meniere's disease is a complex inner ear disorder that can be challenging to diagnose, especially when it comes to differential diagnosis. The following conditions should be considered in the differential diagnosis of active cochleovestibular Meniere's disease:

• Vestibular Migraine: This condition can mimic the symptoms of Meniere's disease, including vertigo, tinnitus, and hearing loss. However, vestibular migraine is typically characterized by a shorter duration of episodes and a stronger association with migraines [13].
• Otosclerosis: This condition can cause fluctuating hearing loss and vertigo, similar to Meniere's disease. However, otosclerosis is typically associated with a fixed sensorineural hearing loss and a lack of vestibular symptoms in the majority of patients [12].
• Acute Vestibular Labyrinthitis or Neuronitis: This condition can cause short-lived episodes of vertigo that may be mistaken for Meniere's disease. However, the episodes are typically shorter in duration and are not associated with hearing loss or tinnitus [12].
• Migraine-Associated Vertigo (MAV): MAV is a type of vestibular disorder that can mimic the symptoms of Meniere's disease, including vert