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M¨¦ni¨¨re¡¯s disease is a balance disorder about which relatively little is known to this day, save that it is most likely caused by an inflammation of the endolymphatic sac of the inner ear. The cause of this retention of endolymph fluid is not presently understood. However, certain factors have been noted to potentially be involved with its occurrence, including certain infections, such as those of the inner ear or upper respiratory tract, the consumption or overconsumption of certain chemicals, including caffeine, aspirin, nicotine, alcohol, and even salt. Specific types of head trauma may also cause the condition. Despite these associations, the disease does not generally occur as a direct result of any of these factors alone.
The condition, first identified by French physician Prosper M¨¦ni¨¨re in the mid-nineteenth century, is generally identified by its symptoms. As it is a balance disorder of the inner ear, sporadic attacks of vertigo, or an irrational sensation of movement or imbalance, are common. Sometimes the sensation of imbalance is so severe as to result in extreme nausea and vomiting, as with many disorders of the inner ear. Pressure is frequently felt in one or both ears. More rarely, temporary or permanent hearing loss is experienced, along with tinnitus, a usually low-pitched sensation roar or hiss that does not leave the ears. These symptoms may swell in intensity preceding an attack of vertigo.
The symptoms produced by M¨¦ni¨¨re¡¯s disease can often resemble those of certain neurologic disorders, including a tumor afflicting the vestibulocochlear nerve (cranial nerve VIII), which is responsible for transmission of information from the inner ear. The presence or absence of such a tumor may be verified by an MRI. A physical examination with consideration of one's medical history may aid in proper diagnosis.
While there is no cure for M¨¦ni¨¨re¡¯s disease at present, there are treatments aimed at reducing the frequency of vertigo attacks and other symptoms by reducing the swelling of the endolympatic sacs. These include the possible use of diuretics, antihistamines, and steroids. Other drugs, called vestibular suppressants, aim to suppress the effectiveness of the inner ear's function, and may thus reduce the frequency of vertigo attacks in that manner. General sedatives, such as Valium, may have a similar effect. Some stimulants and other commonly consumed substances, if avoided, may help an individual to avoid attacks as well. These include most notably caffeine, tobacco, and alcohol. Limiting daily stressors may also help to reduce the severity of the condition.
There are surgical options to treat M¨¦ni¨¨re¡¯s disease, additionally, but as is often the case, surgery is reserved as a recommendation only for those who are debilitated by an extremely severe case. The biggest risk with surgery is that it may produce a permanent hearing impairment, potentially to the point of deafness. This risk may be considered less serious if only one ear is afflicted, as partial hearing would remain even in the worst of circumstances. Consult your physician about all the risks of surgery for M¨¦ni¨¨re¡¯s disease before considering it as an option. Some physicians may be reluctant to recommend a patient for such a procedure unless it is absolutely necessary.
It may be of anecdotal interest that the first American in space, Alan Shepard, was diagnosed with the disease after his first historic flight. He later received surgery for the condition, which was successful, allowing him to continue to pursue his career in spaceflight. |
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