Meniere's disease: causes, symptoms and treatments of this disease of the inner ear
Menière's disease: what are we talking about?
Menière's disease (or "endolymphatic hydrops" in medical language) takes its name from the French doctor who discovered it in the 19th century: Prosper Menière.
This disorder of the inner ear usually occurs between 20 and 50 years of age and is more likely to occur in women, who make up between 60% and 65% of patients. Not contagious, Menière's disease is not uncommon: depending on the country, 1 in 600 to 10,000 adults is concerned.
What is it exactly? Menière's disease is characterized by repeated seizures that usually last between 1 hour and 6 hours (more rarely up to 24 hours): they combine dizziness, buzzing in the ear and hearing loss. which concerns in particular the bass sounds. In 80% of cases, Menière's disease reaches only one ear.
Sometimes preceded by headaches, these seizures are often without any warning sign: they begin with a sensation of "plugged ear" with a drop in hearing (we talk about hearing loss) and buzzing, ringing, snoring, whistling ... ear (these are tinnitus).
During a crisis, the patient feels that "everything revolves around him": this can lead to nausea, vomiting, jerky eye movements (nystagmus) or even falls in some extreme cases - we then speak of crises " Otolithic Tumarkin ".
To know : The severity of Menière's disease is obviously not the same for all patients - periodicity, intensity and duration of seizures are highly variable!
What are the causes of Meniere's disease?
The exact causes of Meniere's disease are, at present, still unknown. However, experts put forward several hypotheses: this pathology could occur in response to external aggressions (viruses, traumas ...), in connection with certain allergies or because of a disruption of the immune system (ie say: an autoimmune origin).
Warning : Meniere's disease should not be confused with Menière's syndrome, where the symptoms (vertigo, tinnitus, hearing loss) are related to an ear infection and disappear with the healing of the ear.
What is the origin of the symptoms? Hang in there, it's a little technical: everything starts in the inner ear, the deepest part of the ear that plays a role in the hearing and balance of the body. In the inner ear, there are two key organs: the cochlea (a small snail-shaped organ responsible for transforming sounds into electrical signals that will be decoded by the brain) and the vestibular apparatus (composed of 3 channels it allows the maintenance of the balance of the body in space).
The cochlea and the vestibular apparatus are two hollow organs: they are filled with a liquid (called the endolymph) and specialized cells (the hair cells). In people suffering from Menière's disease, the endolymph is present in excess: this causes abnormal pressure on the hair cells and this causes both auditory symptoms (such as tinnitus) and disturbances of the balance. (dizziness).
Meniere's disease: how to diagnose it?
To confirm the diagnosis of Meniere's disease (and check that it is not something else!), The doctor can perform several tests:
- Audiometric tests to assess hearing loss,
- Caloric tests used to measure the involuntary movements of the eyes (nystagmus) during vertigo,
- Rotatory tests that verify the proper functioning of the vestibular apparatus,
- "Auditory evoked potentials" which consist of recording the electrical activity of the auditory pathways to the brain in response to sound stimulation,
- A CT scan or magnetic resonance imaging (MRI).
To know : Risk factors for Meniere's disease include family history, pre-existing autoimmune diseases, allergies, head trauma and / or ear and, very rarely, syphilis.
What treatments against Meniere's disease?
There is no cure for Meniere's disease permanently. However, some therapeutic strategies can limit symptoms and live better with the disease:
During a crisis. A cocktail of 3 drugs - oral or intravenous depending on the severity of the attack - helps to reduce the symptoms: anxiolytics (benzodiazepines) to decrease the sensitivity of the vestibular system, anti-vertiginous (such as acetyl-leucine) against vertigo, and anti-emetic drugs (anti-emetics) against nausea.
The background treatment. It aims to improve the patient's quality of life by reducing the frequency of seizures and by preventing (as much as possible) the deterioration of hearing. The goal? To lower the pressure of the endolymph in the inner ear. Can be used: anti-vertiginous, diuretic drugs (hydrochlorothiazide, triamterene or acetazolamide), antihistamines, corticosteroids ...
When drugs are ineffective, a vestibular rehabilitation may be considered: this specialty of physiotherapy can re-educate the balance of the patient by strengthening the complementary mechanisms that normally occur in the balance.
In addition, in less than 20% of cases, the surgery may be necessary - decompression of the endolymphatic sac, chemical labyrinthectomy, surgical labyrinthectomy or vestibular neurotomy.
To know : in parallel with "classic" treatments, psychological management is also recommended since anxiety and stress favor the onset of seizures. In addition, a balanced diet also makes it easier to live with Meniere's disease: salt, sugar, caffeine, tobacco and alcohol are avoided.
Association France Tinnitus
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