Meniere’s disease

Synonyms in a broader sense

Menière’s disease; inner ear dizziness, sudden hearing loss, vertigo, organ of balance English: Menière’s disease

Definition Menière’s disease

Menière’s disease is a disease of the inner ear and was first and impressively described in 1861 by the French physician Prosper Menière. Meniere’s disease is characterized by an increased accumulation of fluid (hydrops) in the membranous labyrinth of the inner ear (see Anatomy of the ear). This results in a pathological increase in inner ear pressure. This increase in pressure leads to the typical signs of illness (symptoms/complaints): sudden, unprovoked vertigo, unilateral ringing in the ears (tinnitus) and unilateral hearing loss or hearing impairment. Nausea and vomiting may also occur.

Occurrence / Frequency

The frequency (incidence) of this inner ear disease is estimated at 1:1000 in industrialized countries. Especially people between 40 and 60 years of age are affected by the Menière’s disease ́schen. Every 5th patient has a positive family history, i.e. a first-degree relative also suffers from Menière’s disease, which is why a genetic component is suspected. It is possible that viral infections, smoking, allergies, stress and alcohol consumption may have contributed to the occurrence of the disease.

Cause/Genesis

The origin of the disease (pathogenesis) is not fully understood. It is assumed that there is a mismatch between the production and removal of inner ear fluid and the following explanations are given: A defective production of endolymph (inner ear fluid) takes place, the fluid contained in the membranous labyrinth of the inner ear. This is either a quantitative, i.e. quantitative, production disorder or a qualitative disorder in which there is a change in the composition of the inner ear fluid.

The resulting high pressure causes a rupture of the endolymphatic tube and the endolymph penetrates the organ of equilibrium, leading to false reports of the sense of balance and the inner ear. The mixing of endo- and perilymph leads to the typical meniere symptoms: a tear in the endolymphatic tube or a permeability disorder at the boundary membranes between the bony and membranous labyrinth are possible reasons for the development of the symptoms in the patient. It is suspected that the mixing of potassium-rich (endolymph) and sodium-rich (perilymph) fluids damages the cells of the sense of hearing (hair cells).

You can find out more about other causes under our topic: Dizziness that can be caused by the inner ear

The uptake (absorption) of the endolymph into the saccus endolymphaticus, a sac (sacculus) of the inner ear filled with endolyphe, which can also be called the “endolymph reservoir”, is disturbed. – The ductus endolymphaticus is closed and is directly connected to the cochlea and the arcade system, which conducts the endolyphe to the reservoir (saccus endolymphaticus). – The saccus endolymohaticus releases oncotically active substances, i.e. substances which have a water-supporting effect, into the endolymphatic space.
Vertigo
Tinnitus
Hearing loss. 1. semicircular canals 2. sacculus 3. utriculusSince the metabolism of the inner ear is a very complex process, it can be disturbed even by minor influences. In addition, the metabolism of the inner ear is influenced by the autonomic nervous system.

The vegetative nervous system is in turn connected with the emotional state of the human being. For these reasons it is assumed that psychologically stressful situations and increased stress can also be a trigger for Menière’s disease. It is also interesting to note that many people with Menière’s disease have a similar personality profile.

Among the frequently observed character traits of patients is a tendency towards perfectionism and ambition. These traits often lead to the patients putting themselves under great pressure. Furthermore, seizures of Menière’s disease are often provoked by stress situations, the seizures then trigger increased stress. Thus, patients can quickly find themselves in a vicious circle of stress and seizures. Relaxation exercises and psychotherapy help many patients to get better.