Diseases of the vestibular organ | Balance

Diseases of the vestibular organ

Menière’s disease or Menière’s disease is a disease of the inner ear, which manifests itself through the three characteristic symptoms of vertigo attacks, ringing in the ears and hearing loss. The dizziness attacks usually start suddenly and unpredictably and can last from a few minutes to even hours. In those affected, everything seems to turn around and they suffer from nausea and vomiting.

The auricle (tinnitus) is paired with a hearing loss on the affected side. The symptoms are usually only noticeable in one ear. The Ménière’s attacks occur intermittently and are repeated at irregular intervals.

Most frequently affected are people between the ages of 40 and 60. The cause of this disease is a so-called “endolymphatic hydrops”. As a result of a shift in mineral salts (electrolytes), an increase in volume of the endolymph in the inner ear occurs, which is thereby stretched and increases its pressure, thereby detecting false sensory impressions.

What triggers this increase in fluid has not yet been clarified. This also makes the therapy of Menière’s disease more difficult. Only the symptoms can be treated.

On the one hand, drugs against dizziness (antivertiginosa) and nausea (antiemetics) help in acute attacks. At the same time, these drugs relieve the strength of a seizure. An alternative are drugs such as betahistine for prevention (prophylaxis), which are supposed to reduce the number of attacks.

Positional vertigo, also known medically as benign paroxysmal positional vertigo (BPLS – benign, seizure-like positional vertigo), is a dizziness that occurs during certain movements or changes in body position. Positional vertigo is in principle a harmless disease, but it is usually very unpleasant for those affected. They often talk about the “carousel in the head“.

The sudden dizziness attack often occurs during rapid changes in head position, such as when straightening up from a lying position, bending forward quickly or turning around in bed, and usually lasts only a few seconds. The background to these dizzy spells is tiny, detached ear stones (otoliths) in the inner ear. When the head is moved, they trigger a kind of suction in the endolymph fluid and feign a strong acceleration to the brain.

The sensory cells of the eye, on the other hand, deliver a stationary, non-moving image. This contradictory information triggers a dizzy spell in the affected person. Therapeutically, an ENT physician can perform special positioning maneuvers on the patient so that the small ear stones leave the archways and come to rest where they no longer trigger dizzy attacks.