3.MENIERE'S VERTIGO

Meniere’s disease is a common condition that can be crippling due to the consequences of the vertigo on the patient’s work, family and social life. This syndrome has a wide variety of causes and a very particular triad of clinical symptoms (dizziness, deafness, tinnitus). The progression of the condition is very unpredictable.

The diagnosis is based on four types of argument:

1) The onset of significant rotational vertigo requiring the patient to lie down and accompanied by intense neurovegetative signs: nausea, vomiting, sweating, diarrhoea. The dizziness lasts 2 to 3 hours and leaves the patient feeling exhausted. After the episode, the patient may feel inebriated.

2) Concomitant unilateral auditory signs:

• tinnitus causing a non-pulsating buzzing, whistling or humming sensation.
• perceptive deafness, which, at first, is predominant in low frequencies and fluctuates enormously. This is also accompanied by the feeling of having a blocked ear, fullness or pressure that wanes after an acute attack. As the condition progresses, the deafness worsens, affecting all frequencies, and reaches a hearing loss plateau of 50 to 70dB. This is accompanied by endocochlear signs: apperception impairment, intolerance to loud noises, diplacusis and sound distortion.

3) Predisposing factors: patients often have a specific psychological background that includes stress, anxiety, fatigue and emotional trauma. In general, the patients are perfectionists, intelligent and obsessive.

4) Disease progression: the disease’s progression varies greatly. The frequency of the vertigo is unpredictable and varies from one patient to another. It can vary from one to two episodes per week or per month or the vertigo may occur only once a year or every two years.