Manifested bouts of dizziness, nausea, vomiting, tinnitus and progressive hearing loss. To diagnose this pathology is necessary to conduct otoscopy (examination of the auditory meatus and the tympanic membrane), the study of hearing and vestibular function analyzer various methods, MRI of the brain brain.
Treatment of the disease is initially using conservative methods. If this is not enough, then carry out the surgical correction and hearing aids. Let us consider what this disease is, what appears is diagnosed and treated.
What it is?
Meniere's disease - a deviation in the inner ear, which causes the liquid amount growth in its cavity, which puts pressure on the cells that control the body orientation in space and balance.
It was first described by the French physician in 1861 and bears his name. The disease occurs in people of all ages from 17 to 70 years, children are almost not affected by Meniere's disease. Often still affects people aged 30-50 years. Gender differences in the frequency of not revealed.
Generally the disease affects the inner ear with one hand, but in 10-15% of the process may initially be bilateral. Sometimes, during the long existence of the disease in a patient, one-way process is transformed into a two-way.
Causes of
There are several theories relating the occurrence of this disease with the response of the inner ear (in a larger amount of labyrinthine fluid and increase the pressure within the labyrinth) at various injury
- Allergic diseases;
- Endocrine disease;
- Vascular diseases;
- Violations of water-salt metabolism;
- Viral diseases;
- Syphilis;
- Deformation Basta valve;
- Blockage of the aqueduct of the vestibule;
- Impaired function of the endolymphatic duct and the endolymphatic sac;
- Reducing the airiness of the temporal bone.
In recent years, the focus is on the theory that explains the occurrence of this disease in violation nerve function, innervate the blood vessels of the inner ear.
The symptoms of Meniere's disease
Onset of the disease is characterized by periods of exacerbations followed by periods of remission during which the ear is completely restored, there is no disability. Turning hearing loss usually lasts for the first 2-3 years of the disease. As the disease progresses even in remission does not fully restore hearing stored vestibular disorders, performance decreases.
The symptoms of Meniere's disease are manifested in the form of attacks, during which the patient is experiencing:
- Tinnitus. Ringing occurs regardless of whether there is in the human environment of the noise source. Whistling ringing, muffled, some patients compare it with the ringing of a bell. Before the start of the attack, ringing tends to increase, and at the time of the attack is capable of change.
- Loss or severely impaired hearing. In this case, the sound of a low frequency of the person can not hear at all. This allows differentiating clinical sign of hearing loss Ménière's disease in which the patient can not hear high-frequency sounds. In this case, a loud sound vibration a person has a special sensitivity and high noise time tracking may experience pain in the ear.
- Dizziness. This condition is often accompanied by a feeling of nausea and vomiting that occurs more than once. Sometimes vertigo is so severe that the person creating the impression that rotates all its surroundings and objects around him. There may be a sense of the body falling through, or its displacement, even though the person is at rest. The attack can last from a few minutes to several hours. The patient's condition is exacerbated when trying to turn his head, so he instinctively tries to sit or lie down, closing his eyes. (See also: Vertigo - types and causes)
- pressure feeling of fullness in the ear. Distention and discomfort occurs due to accumulation of fluid in the inner ear cavity. This feeling is particularly strong before the attack.
- During the attack there nystagmus - rapid oscillatory movement of the eyeballs. Strengthening of nystagmus noted at the time when the patient lies on the affected ear.
- Shortness of breath, tachycardia, paleness of the skin face, increased sweating.
- Sudden fall. This is a pretty formidable symptom that arises from the lack of coordination. This is due to a violation of the deformation structures of the inner ear that causes activation of vestibular reflexes. In this case, the patient shakes from side to side, sometimes it falls or changes position, in an attempt to keep his balance. The main danger lies in the fact that the precursors of impending activation of vestibular reflexes there. Therefore, during the fall of a person could be seriously injured.
- After the attack is complete hearing loss in humans is stored, it may be noise in the ear, a feeling of heaviness in the head. Also, there is the instability of gait and coordination disorders. The patient feels a sense of weakness. As the disease progresses these symptoms tend to strengthen and become more persistent over time.
- Violations by the hearing progresses. If at the beginning of Meniere's disease a person with difficulty distinguish the sound of a low frequency, then he can not hear the entire audio range. over time, hearing loss becomes an absolute deafness. When a person is deaf, dizzy spells expire.
Most of the patients with Meniere's disease are able to foresee the approaching attack, as it is preceded by a certain aura. It is expressed in violation of coordination, ringing in the ears growing there. Furthermore, there is a feeling of pressure and filling in the ear. In some cases, before the actual attack occurs temporary improvement in hearing.
What to do in case of an attack?
When an attack of vertigo is recommended to lie down and keep your head still, without moving, until after the attack. To reduce the symptoms vertigo attacks can be used Gistaminomimetiki (betahistine) and antihistamines (diphenhydramine, Suprastinum, Phencarolum, Diazolinum, meklozin and t. D.). Use them at the same time does not make sense, since they affect antagonistic. To reduce nausea and vomiting antiemetic agents used during the attack (Reglan and other).
extent of the disease
There are three degrees of the disease:
| easy | Bouts of vestibular function disorders are rare and do not last more than 1-2 hours, often just a few minutes. Followed by a prolonged period of remission, it has virtually no effect on the human capacity for work. |
| Central | Increasing the frequency of attacks of dizziness and nausea, after the restoration of coordination needs a period of rest for 3-5 days. |
| Weight | A person is given a disability due to loss of working capacity. Seizures have continuous nature, from 5 hours to several days. Their frequency is on average 1-5 days. In this case, the restoration of disability can not speak. |
Against the background of this classification distinguish between reversible and irreversible forms of pathology. Reversible - is mild, which is characterized by an increase in the length of periods of remission and recovery of hearing. When irreversible form of the patient's condition worsens or does not have a positive progress, there has been a persistent hearing loss, an increase in the number of attacks, vestibular disorders may be of an ongoing character.
Treatment of Meniere's disease
Although a complete cure of Meniere's disease is not possible, treatment can help relieve symptoms and reduce the frequency of occurrence. During exacerbation of Meniere's disease drug therapy may be to stop a sudden attack of vertigo symptoms, eliminate or reduce nausea and vomiting.
Most often in the treatment of Meniere's disease resort to the following groups of drugs:
- Diuretics (diuretics). Used both during attacks and in remission (courses). The purpose of their use is the removal of excess fluid from the body. This decreases the probability of accumulation of fluid in the inner ear (the speed and volume of the endolymph produced falls). However, some experts have questioned the effectiveness of this group of drugs.
- Antiemetics. This group of funds is necessary in the treatment of (mild) bouts of illness. Drugs in this group affect the smooth muscles of the gastrointestinal tract and on the nervous system, removing nausea, dizziness, vomiting stopping. In remission of their use is not required.
- Means of improving cerebral circulation (nootropic drugs). This group means normalizes metabolism in the brain tissues by regulating the vascular tone in the art. Nootropics can take courses in remission.
- Vasodilators (vasodilators). The formation of the endolymph has a great influence vascular tone. Therefore, in some cases, we recommend the use of vasodilators. Among other things, it relieves headaches (if any), and frequently improves overall health. This group of drugs is not assigned to all patients.
- Antispasmodics. This group of drugs affects the tone of smooth muscles (including vascular). It is used for certain indications to improve the overall well-being of patients during the attack.
In various situations, may resort to other groups of funds. This occurs most often when Meniere's syndrome, where there is another pathology, which must be addressed. In this case, treatment of disease appoint specialized professionals. In case of success will decrease the frequency and intensity of nausea and dizziness. Unfortunately, the treatment of Meniere's disease does not help stop the progressive hearing loss.
Treatment of folk remedies
In the treatment of disease and Meniere's syndrome can be used the following folk remedies:
- Hawthorn. Hawthorn wash, dry and crush. 2 tablespoons resulting product pour boiling water of 300 - 400 ml. For storage, you can use a thermos to drink before a meal during the day.
- Seaweed. Sea kale dried and crushed. The resulting powder eat before dinner teaspoon.
- Inflorescence red clover. Of red clover can prepare a tincture with vodka. 2 tablespoons dry clover pour 500 ml of vodka. Infuse in a dark place, in a glass container for 10 days. The finished tincture drink before eating a teaspoon. Take a long time, for 3 months, at intervals of 10 days.
- Elecampane root. Elecampane root of preparing the infusion. Boil to 200 mL of water and let it cool down (to 30 - 40 degrees), pour 1 teaspoon of dried root in water. Let stand 10 minutes. The resulting solution strain and drink 50 ml per day.
- Inflorescences calendula. Marigold flowers well deduce the excess fluid for dizziness, which can be used in the treatment of disease. Take 10 grams of dried flowers, brew in a thermos 200 ml of hot water (50 - 60 degrees). It can be used for a long time, drinking a tablespoon three times a day.
Traditional medicines can not be a substitute for drugs in this disease, but in combination with drug therapy can alleviate the severity of attacks. In the period of remission, when no attacks, herbal medicine can be a good addition to the basic treatment of Meniere's disease.
operative therapy
With the ineffectiveness of conservative treatment of the symptoms of Meniere's disease, and stores the hearing on the affected side is possible surgical intervention - draining the endolymphatic sac. The purpose of the surgical treatment - to reduce the pressure in the endolymphatic space, reduce the appearance of disease, without damaging the structure of the affected ear. However, the long-term effectiveness of the operation has not yet been proved.
In severe cases expressed dizziness that persists medication, applied t. N. Chemical ablation maze - introduction into the tympanic cavity of ototoxic antibiotics such as gentamicin. This reduces the production of endolymph inner ear cells and abnormal impulses from the diseased labyrinth. Dizzy spells stopped in 90%, the risk of hearing loss of about 15%.
With the ineffectiveness of the above treatment is applied surgical destruction of the vestibular apparatus of the inner ear - labyrinthectomy. Since this method results in deafness, it is used as a last resort.
The prognosis of Meniere's disease
The disease does not pose a threat to life and reduces its duration.
Ménière's disease is unpredictable. It can be characterized by a steady progression, undulating course, and in some cases, and improvement of the state in the form of reduction in seizure frequency (sometimes even without treatment).
Such diagnosis involves restrictions in professional activities (contraindicated for work at height, on a lathe and milling machine, with any rotating construction elements, in terms of noise and vibration, driver's occupation). Sharp incoordination and loss of hearing can cause disability.
Thus, it becomes clear that Meniere's disease - it is not fatal, but the insidious disease, capable of delivering a lot of inconvenience in everyday life and cause loss disability. In connection with the existing symptoms of this disease, many patients are limited in employment and sometimes losing their jobs.
