Meniere's Disease Home Overview
By Professor Bill Gibson AM MD FRACS FRCS [Biographical details] In the Beginning I n 1861, Prosper Ménière (1799-1862) published the classic account of the disease which now bears his name. His account was amazingly clear and comprehensive. He described a condition which was characterised by sudden and recurring attacks of vertigo associated with nausea and vomiting, together with hearing loss, tinnitus and a blocked up feeling in the affected ear. Between attacks the sufferers were in good health although often anxious as to when the next attacks might occur. Until Ménière published his account, the disease was believed to be caused by cerebral apoplexy (brain disturbance). Those afflicted by Ménières disease will be pleased to learn that his concepts are correct and the disease is entirely confined to the inner ear. There are three main stages through which the disease may progress. The rate of progression from one stage to the next varies greatly between individuals. Stage One The earliest stage of Ménières disease is dominated by attacks of dizziness. The attacks are not precipitated by sudden movements and cause a feeling of turning (vertigo) which lasts for at least 15 minutes and sometimes persists for hours. The vertigo is associated with nausea, usually vomiting and other symptoms such as sweating or diarrhoea can occur. Even slight head movements aggravate the vertigo and may cause vomiting. Sympathetic relatives may transport the patient to hospital but the journey can aggravate the situation. At the hospital the patient usually waits to be seen and by the time the doctor arrives the attack is subsiding. It is better to lie down in bed and if possible take some prochlorperazine, which is an anti-emetic and vestibular suppressant. If there is major concern ask the family doctor to come to the house. Intramuscular injection (or a suppository) of prochlorperazine or an equivalent medication helps to relieve the attack. | |
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