Meniere’s Syndrome

What is Meniere’s Syndrome?

This is a condition of the balance mechanism, characterized by intermittent attacks—usually severe—involving vertigo, nausea, vomiting, tinnitus (ringing in the ears) and progressive deafness. The exact causes are unknown.

This strange disease with no recognizable cause invariably comes on suddenly, progresses and worsens. But remissions can occur, and may last weeks, months or years. The vestibular and cochlear elements are involved, causing hearing and balance disturbances.

Meniere’s Syndrome Symptoms

The typical symptoms are giddiness, vomiting, tinnitus and deafness. There may be long intervals of freedom between attacks. Sudden onset of giddiness with vomiting that may be so severe as to leave the patient helpless is common. This may last for a number of hours or even days.

Tinnitus may precede or accompany the vertigo, and it may have a rotatory element. Nystagmus (certain quick eye movements) may take place during an attack. Deafness occurs, and is sensorineural in nature. During an attack it may be severe.

All symptoms tend to pass off, and hearing returns completely to normal once again. If attacks become more frequent (which they often do), the situation tends to worsen until in severe cases there is a final total loss of hearing. Suddenness of onset is a characteristic feature of the syndrome. The patient may awaken early in the morning with symptoms in evidence. Remissions may be short or long-lived. The disease is often on one side only, but bilateral involvement may occur.

Attacks usually come on suddenly with a buzzing noise in the ears. This is immediately followed by intense vertigo and the desire to vomit. Often it is so severe and sudden that the patient has the sensation of being hurled to the ground. However, most patients who have experienced it before have time either to sit or lie down and protect themselves from injury. Occasionally there may be transient unconsciousness. The eyes turn to the affected side in quick movements called nystagmus. An acute attack may last from 15 to 60 minutes and the after-effects may persist for many hours. Often the patient is fearful to move lest a new attack take place. It may occur during sleep, the patient awakening with an attack that is accentuated by movement of the head.

Meniere’s disease is characterized by gradual, progressive deafness, which finally may be permanent on the affected

Meniere’s Syndrome Treatment

This must be under medical supervision, for the doctor must check the nervous and other systems to ascertain that there is no other organic lesion causing the attacks. This is essential.

Medication often produces excellent results, although each patient varies. Prochlorperazine (tablets, injection and suppositories) may be used. Betahistinc (Serc) or cyclizinc administered orally often assist. Various sedatives are used, and these also are of value. Antihistamine medication often brings relief

The doctor usually has a particular line of therapy, generally involving the use of some of the items mentioned. Many patients who regularly suffer attacks know their medication, and with experience can administer it themselves if an attack occurs or seems imminent.

Occasionally surgery is carried out if the doctors can be certain which side is affected (often it is both), and when deafness has taken place. However, most patients have mild attacks infrequently, and surgery is not usually necessary.

There is no satisfactory treatment that will guarantee freedom from further attacks, or a cure. In acute stages, bed rest is essential, and empirical medical treatment is usually given. This is often in the form of sedatives and tranquillizers, or medication such as prochlorperazine, which seem to have a decidedly beneficial effect.

For the long-term treatment, many preparations have been tried with dubious results. Probably prochlorperazine is currently one of the best. Antihistamines may assist. They have a mildly sedative effect, and are claimed to assist travel sickness, which is probably a related disorder. In recent years much has been written in the medical journals as to the possible benefits of “decompression surgery,” and this is now often carried out in suitable cases. Long-term results are variable.