It most often starts in people 40 to 60 years old. Females are more commonly affected than males. After 5 to 15 years of symptoms, the episodes of the world spinning sometimes stop and the person is left with loss of balance, poor hearing in the affected ear, and ringing or other sounds in the affected ear or ears. Signs and symptoms
Ménières is characterized by recurrent episodes of vertigo, fluctuating hearing loss, and tinnitus; episodes may be preceded by a headache and a feeling of fullness in the ears. People may also experience additional symptoms related to irregular reactions of the autonomic nervous system. These symptoms are not symptoms of Menieres disease per se, but rather are side effects resulting from failure of the organ of hearing and balance, and include nausea, vomiting, and sweating, which are typically symptoms of vertigo, and not of Ménières. This includes a sensation of being pushed sharply to the floor from behind. Sudden falls without loss of consciousness (drop attacks) may be experienced by some people. Causes
The cause of Ménières disease is unclear, but likely involves both genetic and environmental factors. A number of theories exist including constrictions in blood vessels, viral infections, and autoimmune reactions. Mechanism
The initial triggers of Ménières disease are not fully understood, with a variety of potential inflammatory causes that lead to endolymphatic hydrops (EH), a distension of the endolymphatic spaces in the inner ear.
Hearing loss usually fluctuates in the beginning stages and becomes more permanent in later stages. MD has a course of 5–15 years, and people generally end up with mild disequilibrium, tinnitus, and moderate hearing loss in one ear. Epidemiology
From 3 to 11% of diagnosed dizziness in neuro-otological clinics are due to MD. The annual incidence rate is estimated to be about 15 cases per 100,000 people and the prevalence rate is about 218 per 100,000, and around 15% of people with Menieres disease are older than 65. In around 9% of cases, a relative also had MD, indicating a genetic predisposition in some cases.The odds of MD are greater for people of white ethnicity, with severe obesity, and women. Several conditions are often comorbid with MD, including arthritis, psoriasis, gastroesophageal reflux disease, irritable bowel syndrome, and migraine. History
The condition is named after the French physician Prosper Menière, who in an 1861 article described the main symptoms and was the first to suggest a single disorder for all of the symptoms, in the combined organ of balance and hearing in the inner ear.The American Academy of Otolaryngology–Head and Neck Surgery Committee on Hearing and Equilibrium set criteria for diagnosing MD, as well as defining two subcategories – cochlear (without vertigo) and vestibular (without deafness).In 1972, the academy defined criteria for diagnosing MD as:
Fluctuating, progressive, sensorineural deafness
Episodic, characteristic definitive spells of vertigo lasting 20 minutes to 24 hours with no unconsciousness, vestibular nystagmus always present.