The
following information was attained with permission from
Symptoms
Ménière's disease is usually
characterized 4 symptoms.
1) Periodic episodes of
rotatory vertigo or dizziness.
2) Fluctuating,
progressive, low-frequency hearing loss
3) Tinnitus
4) A sensation of
"fullness" or pressure in the ear.
Detailed
description of
symptoms
1) Periodic episodes of
rotatory vertigo or dizziness.
Periodic attacks of vertigo ( the so-called
Ménière's "attack") is
the most disruptive of the symptoms to the patient. It is usually the
vertigo
attack which causes the patient to seek medical treatment. Typically,
vertigo
occurs in the form of a series of attacks over a period of weeks or
months,
interspersed by periods of remission of variable duration. The attack
consists
of a period of dizziness or vertigo (dizziness may include a feeling of
unsteadiness; the term vertigo is normally reserved for the perception
of
spinning). The sensation of spinning may produce nystagmus (a beating
of the
eyes from side to side), nausea, vomiting, sweating and all the
symptoms
normally associated with extreme motion sickness. The onset of vertigo
may be
preceeded by a sensation of fullness or pressure in the ear, increased
hearing
loss and tinnitus, as described below. The onset is frequently sudden,
reaching
peak intensity within minutes and lasting for an hour or more before
subsiding.
Unsteadiness may persist for the following hours or days.
Vertigo must
be one of the
worst chronic afflictions to affect the body. The vertigo patient
perceives
either that the world is spinning around them or that they themselves
are
spinning. With many other disabilities, some portion of a normal life
can be
continued. Vertigo disrupts virtually every aspect of life, since the
patient
loses the ability to do anything normally, especially when
movement is
involved. In addition to the obvious hazard of falling, moving around
is
hampered by the fact that even small head movements often make the
spinning
sensation worse. The resulting nausea, sweating and vomiting combine to
make the
patient subjectively very "ill". Vertigo can totally incapacitate the
individual, so they cannot function. Often the patient will confine
themselves
to bed until the symptoms subside.
Most normal
individuals
probably cannot appreciate the devastating impact of this condition.
Most of us
are familiar with mild forms of vertigo or dizziness (from fair rides,
excessive
alcohol consumption, etc.). If you haven't recently experienced
vertigo, try the
following experiment (in a large open space, on a soft surface such as
grass).
Take hold of a heavy object at arms length (my son recommends a school
backpack
full of books) and spin around, leaning slightly backwards to balance
the bag.
Spin around 10-20 times at a rate of about 2 revolutions /second.
Alternatively,
if you don't want to injure yourself by falling over, sit in an
"executive" swivel chair and have someone spin you around as fast as
they can without the chair becoming unstable, for 20-30 seconds. In
both these
cases, you will experience rotatory vertigo for a few seconds when you
stop
rotating. You will have the sensation you are still spinning, your eyes
will
exhibit nystagmus (a beating from side to side) and if you continue,
you may
experience nausea. Based on this experience, you now partially
understand
the problem. There are additional factors which the patient must deal
with. One
is that their vertigo may last from hours to days, compared with the
few seconds
you experienced. With the brief episode you experienced, the vertigo
declined
quickly with time. For a patient, the vertigo may be sustained, or even
increase
in intensity over a few hours. Another difficulty the patient may have
is that
the vertigo can be made worse by "external" stimuli, such as head
movements or loud sounds. Even TVs and radios may have to be avoided.
It should
also be considered that in this exercise, you had control over your
situation
and you knew you could stop when you wanted. You also knew that you
would be
fine tomorrow. The Meniere's patient has to deal with a lack of control
of their
situation, except for the limited control provided by taking
anti-vertiginous
drugs. Even when the symptoms have passed, they must face the stress
and
uncertainty of when the next episode will occur, and whether it will be
more or
less severe than previous ones. It is generally true that most people
underestimate how disruptive episodic rotatory vertigo can be to an
individual's
life.
2)
Fluctuating,
progressive, low-frequency hearing loss
The hearing loss usually affects one ear, which typically loses
sensitivity to
low-frequency (bass) sounds the most. As well as being harder to hear,
sounds
may appear "tinny" or distorted. Loud sounds may cause more discomfort
than normal (loudness intolerance). The hearing loss fluctuates over
time.
Somtimes the hearing may recover to some extent, but then on other days
hearing
may be difficult. In addition, the degree of hearing loss may get
progressively
worse with time, eventually affecting all sound frequencies and hearing
may be
completely lost in the affected ear.
3)
Tinnitus
Tinnitus is sustained, loud "ringing" in the ears. Many normal
individuals experience brief episodes of tinnitus, such as a loud
"ping" which declines over a period of seconds to minutes. The
tinnitus experienced by Ménière's patients is
continual and does not abate
with time, although its intensity may vary. The tinnitus is generally
nonpulsatile. In addition, it may be heard more as a load roaring or
buzzing
sensation, rather than a whistling.
4)
Aural fullness
The feeling of "fullness" in the ear is similar to that experienced by
barometric pressure changes (such as when riding up or down a hill, or
ascending
or descending in an airplane). However, this fullness cannot cleared by
swallowing, as in the case of pressure changes.
|
|
