1

Running Header: Menieres Syndrome

Menieres syndrome
Jonathan Bland
Pathophysiology
Professor Lori McGowan

2
Running Header: Menieres Syndrome

A 32-year-old man has vertigo, nausea, and hearing problems. He was

diagnosed with Menieres syndrome. Meniere's disease is a very disturbing illness,
presenting patients with hearing loss, pressure in the ear, tinnitus, severe imbalance
and vertigo (Levenson, 2011). Vertigo is the most dramatic and distressing symptom of
Meniere's; it is described as a sudden loss of normal balance or equilibrium. The room
may suddenly begin to spin and rotate at high speed. Focusing is difficult, and if the
vertigo continues, nausea and vomiting may occur. Vertigo is commonly caused by
acute labyrinthitis (a viral inflammation of the inner ear), benign positional vertigo (a
condition due to abnormally floating crystals in the inner ear that stimulate the nerve
endings of the inner ear), delayed symptom of head injury, or result of cervical spine
problems (Levenson, 2011). Menieres disease comes in cycles. The patient may suffer
multiple episodes lasting months at times then it subsides. Some patients may have
symptoms at different times of the year or with extra emotional stress. The most
unpredictable and frightening symptom of Meniere's disease is vertigo. The vertigo in
Meniere's disease is thought to result from an accumulation of excessive fluid in the
inner ear. The fluid pressure stretches the membranes that divide the compartments of
the inner ear. As the membranes of the inner ear stretch, hearing diminishes and
tinnitus worsens. When the membranes are severely stretched, the fluids of the inner
ear may rupture them. This results in mixing of the fluids, one rich in sodium, and the
other rich in potassium. The mixture of these fluids is thought to bring on the vertigo
(Levenson, 2011).

3
Running Header: Menieres Syndrome

The treatment of the patient may include modification of personal habits, diets,
stress reduction and regular exercise. This is all extremely important in the overall
treatment of the disease. Medications may be recommended and all treatments are
carefully monitored. Some patients may have to have brain surgery. Some patients are
able to identify "triggers" that can sometimes induce or aggravate their
symptoms. When a trigger is identified then avoidance or treatment of that trigger can
reduce (but not eliminate) the frequency and duration of symptoms and episodes. Not
all episodes of Meniere's disease can be attributed to "triggers (Meniere's Disease,
2011).
Some doctors say that Meniere's "burns itself out," leading patients to erroneously
conclude that Meniere's will simply fade away and that they will be "cured." However,
"burnout" does not mean this at all. "Burnout" refers to a condition where Meniere's
disease has progressed to the point where it has finally destroyed the entire (or nearly
the entire) vestibular function in the affected ear. At the point of burnout, the patient has
little or no vestibular function left and the body may or may not compensate in other
ways. The vestibular function in the other ear may take over and/or the patient may
learn to balance through visual cues (with some degree of difficulty occurring during
darkness). However, nothing stops the relentless progression of Meniere's Disease,
and it will continue to destroy hearing, produce the sense of fullness, and produce
tinnitus -- even in patients who are "stone" deaf (because of Meniere's Disease or
otherwise). While some patients reach a rotational vertigo-free or nearly rotational
vertigo-free, state of burnout, burnout is a progression, not a cure, and there is no

4
Running Header: Menieres Syndrome

certainty of any one patient reaching burnout. Not all doctors (and not all patients)
believe that "burnout" can happen (Meniere's Disease, 2011).

5
Running Header: Menieres Syndrome

Works Cited
Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition. Philadelphia: W.B.
Sauders.

Levenson, M. M. (2011). Meniere's Syndrom. Retrieved April 25, 2011, from Earsugery.org:
http://www.earsurgery.org/site/pages/conditions/menieres-syndrome.php

Meniere's Disease. (2011). Meniere's Disease Information Center. Retrieved April 25, 2011, from
Meniere's Disease Information Center: http://www.menieresinfo.com/start.html#introduction