Name of the Day: MENIERE'S DISEASE [Part 1 of 2]

Nearly 155 years ago, a French physician, Prosper Ménière, presented a paper to the French Academy of Medicine, titled On a particular kind of hearing loss resulting from lesions of the inner ear.  It was also published in the Gazette Medicinale de Paris, a premiere medical publication of the time.

In the paper, Ménière presented cases of a number of patients who suffered episodic vertigo and loss of hearing.  At the time, it was believed, at least by the French medical community, that the source of vertigo was the brain, akin to epileptic seizures.  In his presentation, he also cited a case of young girl who, like the other patients he cited, suffered from vertigo.  Hers, however. began after an inner ear hemorrhage.  

His presentation was met with resistance; the debate even continued all the way into the twentieth century.  His pursuit, which was not to identify a new disease but that vertigo could stem from inner ear damage, would, eventually, result in the identification of the disease that bears his name as its discoverer, Ménière's Disease.

Ménière presented his paper in 1861.  It was not until over a century later, in 1995, that the
Committee on Hearing and Equilibrium of the American Academy of Otolaryngology—Head and Neck Surgery officially recognized Ménière's Disease as "the idiopathic syndrome of endolymphatic hydrops".

What "the idiopathic syndrome of endolymphatic hydrops" means is that the disease, as a result of a excessive build-up of fluid (called endolymph), produces a variety of resulting symptoms.  Symptoms occurring from this fluid build-up include equilibrium(falls may be common), vertigo, lightheadedness, headaches (which may or may not be migraines), tinnitus (which is likely to increase in intensity), sporadic hearing loss (which may become permanent), problems with vision, and vomiting. 

Often, a Ménière's attack is followed by extreme fatigue.  Friends and family members who lack understanding may see the symptoms as non-existent, with some similarity to those who know sufferers of fibromyalgia, and the fatigue as laziness.  Those who have to live with Ménière's Disease might not be a stranger to the refrain:"But you don't look sick."  

Any exact cause(s) are unknown.  There have been several theories over many years of causes for Ménière's attacks, including an autoimmunity condition, circulation problems, viral infection, and even genetics.  While the cause is not yet known, the leading theory seems to be the excessive build-up of fluid itself, which begs the question of why and how the fluid makes its way into the inner ear.

As with most symptoms, there are triggers for a Ménière's attack.  The most common triggers reported are too much stress, emotional upheaval, too much salt in the diet, and any other concurrent illnesses of the patient.  The most common treatments for Ménière's Disease include a salt-reduced or salt-restricted diet, medications, physical therapy and exercise, antibiotic injections into the ear, and, in severe cases, or as a last resort, surgery.

The symptoms can be so serious, they can be life-altering on a large scale, a life-affecting scale.  I recently came across a recent news story out of Holland.  A forty-seven year old mother of two, Gaby Olthuis, suffering from severe tinnitus wanted to end her life via euthanasia.  You will likely have strong feelings on that subject.  This situation was compounded by the fact she was not suffering from a terminal disease.  Below is a short documentary on her story.  It is in Dutch with English subtitles.

No doubt, this documentary will raise serious questions.  I offer it as an example of how bad, how intense, and how suffering-inducing of a condition that it can be in its worst instances.

Terry 

TOMORROW

A LIFE WITH MENIERE'S DISEASE