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Ugeskrift For Laeger Apr 2021Dizziness and vertigo are frequent symptoms in the primary care facility and emergency departments. Episodic vestibular syndrome (EVS) is defined as episodic dizziness,... (Review)
Review
Dizziness and vertigo are frequent symptoms in the primary care facility and emergency departments. Episodic vestibular syndrome (EVS) is defined as episodic dizziness, vertigo or postural imbalance with remission between episodes. EVS can be divided into spontaneous (s-EVS) and triggered EVS (t-EVS). Causes of s-EVS are vestibular migraine, Menière's disease, transient ischaemic attack and vestibular paroxysmia. Causes of t-EVS are benign paroxysmal positionel vertigo, orthostatic hypotension and panick attacks. In this review, we recommend using vestibular syndromes in order to reduce the number of differential diagnoses.
Topics: Benign Paroxysmal Positional Vertigo; Dizziness; Humans; Meniere Disease; Migraine Disorders; Vestibular Diseases
PubMed: 33913418
DOI: No ID Found -
Bratislavske Lekarske Listy 2016The aim of this study is to prove the involvement of the immune response in the etiopathogenesis of some cochleovestibular disorders by a demonstration of antibodies...
OBJECTIVE
The aim of this study is to prove the involvement of the immune response in the etiopathogenesis of some cochleovestibular disorders by a demonstration of antibodies against inner ear antigens and identify the benefits of immunosuppressive therapy.
BACKGROUND
McCabe in 1979 postulated the hypothesis of autoimmune inner ear disease.
METHODS
Sodium dodecyl sulfate polyacrylamid gel electrophoresis and immunoblotting were used to examine the serum of 74 subjects for the presence of antibodies against inner ear antigens. The subjects were divided into three groups: A--subjects with idiopathic progressive sensorineural hearing loss, B--subjects with Menière´s disease, C--healthy subjects. Individuals with proven antibodies received immunosuppressive therapy.
RESULTS
We detected antibodies against inner ear antigens with molecular weight of 30, 50, 60, 80, 100 kDa. In group A they were found in 52% of 25 subjects, in group B in 44% of 25 subjects and they were not detected in group C. An improvement of hearing was recorded in 69% of subjects in group A. An improvement of hearing was observed in 72%, significant relief of vertigo in 81% of subjects in group B.
CONCLUSION
The present study supports the hypothesis of immune-mediated cochleovestibular disease (Tab. 3, Ref. 15).
Topics: Adult; Antibodies; Audiometry, Pure-Tone; Autoantigens; Autoimmunity; Drug Monitoring; Ear, Inner; Female; Hearing Loss, Sensorineural; Humans; Immunologic Tests; Immunosuppressive Agents; Male; Meniere Disease; Middle Aged; Treatment Outcome
PubMed: 26830038
DOI: 10.4149/bll_2016_017 -
Current Opinion in Otolaryngology &... Oct 2023Ménière's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal... (Review)
Review
PURPOSE OF REVIEW
Ménière's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal management continue to be the subject of ongoing debate. Although it is classically believed to be a primary disorder of the inner ear, some clinicians have hypothesized that it is a form of vestibular migraine.
RECENT FINDINGS
Evidence supporting vestibular migraine in the differential of Ménière's disease includes overlap of symptoms, high prevalence of migraines in patients with Ménière's disease, and the efficacy of migraine treatments for symptoms of Ménière's disease in some patients. However, there is far more evidence to support Ménière's disease as a disorder of the inner ear, including genetic and histologic changes of hydrops, imaging studies showing hydropic changes, predominance of low-frequency hearing loss, clinical efficacy of treatments targeted at inflammatory change/hydrops, and clinical efficacy of ablating the vestibular end-organ.
SUMMARY
Although there is conflicting evidence regarding the cause and treatment of Ménière's disease, current evidence favors it as a disorder of the inner ear. Further research is needed to fully understand the mechanisms of Ménière's disease and how to improve diagnosis and treatment outcomes.
Topics: Humans; Meniere Disease; Vestibule, Labyrinth; Deafness; Migraine Disorders; Edema
PubMed: 37610986
DOI: 10.1097/MOO.0000000000000921 -
Current Opinion in Otolaryngology &... Oct 2023To discuss the theory that Meniere's disease (MD) is a variation of otologic migraine rather than an isolated inner ear condition. (Review)
Review
PURPOSE OF REVIEW
To discuss the theory that Meniere's disease (MD) is a variation of otologic migraine rather than an isolated inner ear condition.
RECENT FINDINGS
In contrast to the approximately 12% of the general population suffering from migraine headaches, 51-60% of patients with MD experience migraine headaches. While pathognomonic for MD, endolymphatic hydrops has also been identified in patients with vestibular migraine. Treatment with the integrative neurosensory rehabilitation approach (diet and lifestyle changes, magnesium and riboflavin supplementation, and when needed, prophylactic medication) to treat the underlying migraine process has been highly effective in patients with MD.
SUMMARY
MD can be understood as a manifestation of migraine such that patients with MD can be effectively treated with migraine therapies.
Topics: Humans; Meniere Disease; Endolymphatic Hydrops; Vertigo; Migraine Disorders; Diet
PubMed: 37266702
DOI: 10.1097/MOO.0000000000000908 -
Neuroradiology Nov 2021Ménière's disease (MD) is a clinical syndrome characterized by recurrent episodes of spontaneous vertigo, unilateral fluctuating sensorineural hearing loss, tinnitus,... (Review)
Review
Ménière's disease (MD) is a clinical syndrome characterized by recurrent episodes of spontaneous vertigo, unilateral fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic hydrops is recognized as the pathophysiological substrate of the disease, having been demonstrated in anatomical pathological studies and more recently by magnetic resonance imaging (MRI). The current criteria of the disease, however, remain symptom based and do not include the demonstration of endolymphatic hydrops. The authors review MRI techniques and diagnostic criteria of endolymphatic hydrops and the role of MRI in MD is discussed.
Topics: Endolymphatic Hydrops; Hearing Loss, Sensorineural; Humans; Magnetic Resonance Imaging; Meniere Disease; Tinnitus
PubMed: 34142211
DOI: 10.1007/s00234-021-02744-5 -
Current Opinion in Otolaryngology &... Oct 2023To review the evidence of a possible viral etiology of Meniere's disease, the role of antiviral therapy, as well as other infectious disease processes that may mimic... (Review)
Review
PURPOSE OF REVIEW
To review the evidence of a possible viral etiology of Meniere's disease, the role of antiviral therapy, as well as other infectious disease processes that may mimic Meniere's disease. Better understanding of the etiology of Meniere's disease and the role of various infectious disease processes may allow for more effective diagnosis and management.
RECENT FINDINGS
There is evidence that viral infections - to Herpes simplex virus, cytomegalovirus, Epstein Barr virus, influenza, adenovirus, Coxsackie virus B, and Varicella Zoster Virus - may be involved in the development of Meniere's disease, however the evidence is inconsistent and the underlying mechanism remains theoretical. Nevertheless, antiviral therapy may be effective for a subset of patients with Meniere's disease. Lastly, other infectious diseases including Lyme disease and syphilis can present with symptoms similar to Meniere's disease. It is important to discern these from Meniere's disease to determine the appropriate treatment.
SUMMARY
There is a paucity of high-quality evidence to support a viral etiology of Meniere's disease, and the current evidence appears circumstantial and inconsistent. Additional research is necessary to establish the mechanism and causative pathogens. Antiviral therapy may provide therapeutic benefit for a subset of patients with Meniere's disease. Furthermore, clinicians should be aware of other infectious mimics of Meniere's disease and include them in the differential diagnosis of patients presenting with Meniere's-like symptoms. Research on this subject continues to evolve, and data from these studies represent a growing repository of evidence that can be used to guide clinical decision-making.
Topics: Humans; Meniere Disease; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Communicable Diseases; Antiviral Agents
PubMed: 37387674
DOI: 10.1097/MOO.0000000000000909 -
Molecular Biology Reports Mar 2023Meniere Disease (MD) is an idiopathic inner ear disease with complex etiology and pathogenesis, which is still unclear. With the development in gene analysis technology,... (Review)
Review
Meniere Disease (MD) is an idiopathic inner ear disease with complex etiology and pathogenesis, which is still unclear. With the development in gene analysis technology, the genetic research of MD has attracted extensive attention, resulting in a large number of studies on the research of the relationship between human genes and MD. This paper aims to review the studies on this topic in recent years. The studies mainly focused on the genetics of familial MD and the correlation between MD and potentially related functional genes. The results of these studies have demonstrated the complexity and diversity of the pathogenesis of MD with both genetic and epigenetic alterations, suggesting that MD might be related to inflammation, immunity, aqua and ion balance in the lymphatic fluid, virus infection, metabolism, and abnormal function of nerve conduction. The finding of rare mutations in TECTA, MYO7A and OTOG genes and other genes such as CDH23, PCDH15 and ADGRV1 in the same families suggest that the integrity of the stereocilia and their interaction with the tectorial and otolithic membranes could be involved in the pathophysiology of familial MD.
Topics: Humans; Meniere Disease; Alleles; Mutation
PubMed: 36565421
DOI: 10.1007/s11033-022-08149-8 -
Psychology, Health & Medicine Apr 2023Meniere's disease is an otological disease characterized by various symptoms that include episodic peripheral vertigo, sensorineural hearing loss, tinnitus, and aural...
Meniere's disease is an otological disease characterized by various symptoms that include episodic peripheral vertigo, sensorineural hearing loss, tinnitus, and aural fullness, all of which deteriorate the maintenance of daily activities. We aimed to investigate cognitive function in Meniere's disease patients and compare their results to those of healthy controls. Eighteen patients diagnosed with definite Meniere's disease without any psychiatric, neurological or otological comorbidity, and 30 healthy controls with normal cognitive functions were included in the study. General cognitive status, attention, verbal memory, visual memory, executive and visuospatial function were measured by detailed neuropsychological tests in both groups. In the patients with Meniere's disease, pure-tone hearing thresholds, and speech discrimination scores were also measured. Patients with Meniere's disease showed lower levels of performance in the trail making test, Oktem verbal memory processes, Rey Complex Figure Test, Wisconsin Card Sorting Test, semantic and phonemic fluency than did healthy controls. In other words, there were deficits in attention, recognition and recall in verbal memory, recall in visual memory, visual spatial construction, and planning skills in patients with Meniere's disease. Education years and depression scores of participants had a significant effect on cognitive function in all groups. This study is an update and confirmation of the findings of studies showing cognitive impairment in patients with Meniere's disease. In addition to previous findings, this study found a decrease in executive function performance in patients with Meniere's disease compared to healthy controls. Unlike previous studies, this study comprehensively addressed all cognitive functions and included a control group. Our results emphasize that executive functions, which are high-level cognitive processes, may affect the compliance of patients with Meniere's disease treatment and follow-up processes.
Topics: Humans; Meniere Disease; Vertigo; Tinnitus; Hearing Loss, Sensorineural; Cognition
PubMed: 36369758
DOI: 10.1080/13548506.2022.2144637 -
Otolaryngologic Clinics of North America Dec 2017Allergy is commonly associated with conditions such as rhinitis, sinusitis, and asthma, but the relationship between allergy and otologic diseases is less clear. This... (Review)
Review
Allergy is commonly associated with conditions such as rhinitis, sinusitis, and asthma, but the relationship between allergy and otologic diseases is less clear. This article examines the evidence for a relationship between allergic disease and several common otologic conditions, including otitis media with effusion, eosinophilic otitis media, and Ménière's disease.
Topics: Eustachian Tube; Humans; Hypersensitivity; Meniere Disease; Otitis Media with Effusion
PubMed: 28992951
DOI: 10.1016/j.otc.2017.08.005 -
Otolaryngology--head and Neck Surgery :... Sep 2018Fundamentally, Ménière's disease is a constellation of symptoms and, as such, may represent the final common pathway for a number of disease processes, as opposed to... (Review)
Review
Fundamentally, Ménière's disease is a constellation of symptoms and, as such, may represent the final common pathway for a number of disease processes, as opposed to being the consequence of a single isolated pathology. Within this type of consideration, much can be learned regarding the etiology, presentation, prognosis, and treatment of these individual conditions by applying subtyping techniques currently employed to better understand similar disease processes that are encountered in other allied fields of medicine. This commentary proposes the principles, required processes, and benefits of subtyping for Ménière's disease.
Topics: Combined Modality Therapy; Comprehension; Female; Genetic Predisposition to Disease; Humans; Male; Meniere Disease; Middle Aged; Needs Assessment; Prognosis
PubMed: 29688822
DOI: 10.1177/0194599818773077