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Medical Forum / Diseases and Disorders / Tinnitus / May 2004The exact definition of Meniere disease?
My ENT doctorS where I am are of the firm view that in order to be qualified as a Meniere sufferer a/o a sufferer of inner ear disorder, one has to experience vertigo a/o dizziness. Without such an element, the patient could best be described as suffering from poor blood circulaton in the inner ear or head. I have been led down this path for the past 6 months or even more. It is about time that I would like to be enlightened. Thank You in advance, FP fyfpoon@hotmail.com (francispoon) wrote in part: >My ENT doctorS where I am are of the firm view that in order to be >qualified as a Meniere sufferer a/o a sufferer of inner ear disorder, [quoted text clipped - 7 lines] > >FP (Otolaryngology/Head & Neck Surgery 1995; Volume 113: page 181) Essential feature - Sensorineural hearing loss documented on at least one occasion Certain Menieres - Histopathologic confirmation and the "Definite Menieres" criteria Definite Menieres - Two or more attacks of vertigo lasting more than 20 minutes - Audiometrically documented hearing loss - Tinnitus or aural fullness - Other causes excluded Probable Menieres - At least one vertigo episode - Audiometrically documented hearing loss - Tinnitus or aural fullness - Other causes excluded Possible Menieres - Episodic vertigo without documented hearing loss - Sensorineural hearing loss, fluctuating or fixed, with disequilibrium but without definite episodes of vertigo - Other causes excluded  SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > fyfpoon@hotmail.com (francispoon) wrote in part: > [quoted text clipped - 31 lines] > without definite episodes of vertigo > - Other causes excluded Thank you. Questions: (1)Is Meniere necessarily connected with 'excess fluid retention' in the inner ear? (2)Does excess fluid retention in the inner ear necessarily lead to the experience of vertigo and dizziness? My ENT doctorS are of the view that _excess fluid retention_ invariably leads to vertigo a/o dizziness. Thus if a patient had not experienced vertigo or dizziness, he would not have had excess retention of fluid in his inner ear. THX FP fyfpoon@hotmail.com (francispoon) wrote in part: >Questions: >(1)Is Meniere necessarily connected with 'excess fluid retention' in >the inner ear? It appears to be *associated* with excess endolymph, one of the inner ear fluids. "Retention" may not be the reason. Overproduction or something else entirely may be at fault. It is also possible that the fluid buildup is not really the cause of symptoms, though it seems very likely that it is. Some of the newer MRI-based imaging devices may be able to answer this question any day now. >(2)Does excess fluid retention in the inner ear necessarily lead to >the experience of vertigo and dizziness? No. At least, hydrops (excess fluid) has been experimentally induced in laboratory animals without any vertigo or dizziness resulting. SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > fyfpoon@hotmail.com (francispoon) wrote in part: > [quoted text clipped - 6 lines] > entirely may be at fault. It is also possible that the fluid buildup is not > really the cause of symptoms, though it seems very likely that it is. Could the over-production of excess endolymph or this "something else" be 'cured'? Lately, I have been applying 20 mg of Lasix and the reduction of this fluid, whatever it is, seems to have lowered the volume of my T and the related tension. Any scientific explanation for this observation of mine? >>Some of the newer MRI-based imaging devices may be able to answer this question any day now. Please kindly inform us when that day comes. We are the desperate masses. Thank you for your information. FP ============================================ > >(2)Does excess fluid retention in the inner ear necessarily lead to > >the experience of vertigo and dizziness? > > No. At least, hydrops (excess fluid) has been experimentally induced in > laboratory animals without any vertigo or dizziness resulting. Meniere's is essentially vertgio, tinnitus , hearing loss and a feeling of fullness in the ear.. It is recurrent - not a single epissode. Many patietns respond to lowering the endolympnatic pressure. This has been done by placing shunts, medications, diet,etc. Cause? Could be a virus, autoimmune or a dysfunction of the fluid system. But you can have meniere's without all four symptoms. You can have it with only one symptom. Diagnosis requires a high degree of suspicion and a protocol for treatment. Helps to diagnosiis: it came on suddenly. I had it a year ago and it lasted 3 weeks and went away and I was fine. I feeel a pressure and then my tinnitus gets louder. As long as I avoid salt I am OK. I went to a party and ate salty things and the symptoms returned. A good self test is a low salt high potassium diet with lots fo distilled water. Although Lasix is a very good diuretic and Diamox is a poor diruretic, Diamox directly affects the fluid system of the inner ear wheras Lasix affects it indirectly. Murray Grossan, M.D. http://www.ent-consult.com Although EH is a pathologic finding, Menieres disease is a clinical entity, and later research has not been able to find a significant correlation between Menieres disease and EH. The etiology of Menieres disease is still unknown; consequently, there is no therapy with lasting effect without complications. The definition of Menieres disease has evolved and was updated in 1995; however, the conclusion was that very little was known about the etiology of the disease. Tinnitus is a pain in the neck Elly's Tinnitus Resources http://eebee.net/ http://meniere.eebee.net/ For email: elly at eebee.cjb.net >fyfpoon@hotmail.com (francispoon) wrote in part: > [quoted text clipped - 31 lines] >without definite episodes of vertigo >- Other causes excluded consequently, there is no therapy with lasting effect without complications. strongly disagree with this statement. There are excellent therapies that do work. Murray Grossan, M.D. http://www.ent-consult.com > consequently, there is no therapy > with lasting effect without complications. > > strongly disagree with this statement. There are excellent therapies that do > work. Kindly suggest a few. I am looking forward to having my excess inner ear fluid production 'cured'. THKS FP =============================================== > Murray Grossan, M.D. > http://www.ent-consult.com
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