Meniere’s disease – What is it?

Synonyms in a broader sense

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

Definition of 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 the disease (symptom complaints): sudden, unprovoked vertigo, unilateral ringing in the ears (tinnitus) and unilateral hearing loss or hearing impairment. Nausea and vomiting may also occur.

Occurrence and Frequency

The frequency (incidence) of this inner ear disease is estimated at 1:1000 in industrialized countries. Mainly people between the ages of 40 and 60 are affected by the Menière’s disease ́schen Every 5th patient has a positive family history, i.e. a first-degree relative is also affected by 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.

Causes

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 can be found: 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 endolymph 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 endolymphatic sac, a sac of the inner ear filled with endolypmhe, which can also be called the “endolymph reservoir”, is disturbed.
  • There is a closure of the ductus endolymphaticus, which is in direct connection with the cochlea as well as with the arcade system and conducts the endolypm to the reservoir (saccus endolymphaticus).
  • The Saccus endolymohaticus releases oncotically active substances, i.e. those substances which have a water-supporting effect, into the endolymphatic space.
  • Dizzy spell
  • Tinnitus
  • Hearing loss.

The so-called Menière’s triad, the occurrence of three typical symptoms in this disease, is composed of These symptoms improve after minutes to hours and occur repeatedly at irregular intervals. The patient does not know when and to what extent the next seizure will occur, which can lead to uncertainty and fear. Particularly at the beginning of the disease, symptoms can also occur alone and not in the typical threefold pattern, so that the diagnosis of Meniere’s disease as the cause of e.g. rotary vertigo is difficult and may not be possible until the disease progresses.

Read next article in this series:

All articles in this series:

  1. Meniere’s disease – What is it?
  2. Diagnosis of Menière’s disease
  3. Therapy
  4. Sports for Menière’s disease