Meniere’s disease –Old Perspectives

Meniere’s disease was first described by Prosper Meniere in the 1800s. Up until that time, vertigo was thought to be the result of epileptic type seizures. Meniere was the first to publicly suggest that the inner ear was the cause of the collection of symptoms including hearing loss and vertigo, but he thought that they were the result of a hemorrhage of the inner ear. For those interested in a detailed history regarding Dr. Meniere, see the excellent article by Dr. Robert Baloh, published in 2001.

 There have been many theories ascribed to the causes of Meniere’s symptoms. We discussed one plausible theory last week involving a blockage of one of the ducts connecting different fluid filled chambers within the inner ear. There has been a widely accepted similar theory around for years, where it was suspected that a different duct connecting to the endolymphatic sac could become blocked. This theory led to a long standing surgical technique used to treat Meniere’s disease where a shunt is created to offer an alternative fluid pathway for the inner ear fluid (endolymph).

Others have suggested that Meniere’s disease is not the result of a blockage at all, but rather an over production of endolymph by the stria vascularis, while others have theorized that Meniere’s episodes could involve disrupted blood flow to the labyrinth, an allergic response or an immune system response. Most recently, it has been suggested that Meniere’s disease may be a variant of migraine. Many believe that a variety of abnormalities, including those listed above, may be responsible for the hearing loss and vertigo symptoms, and that there is not one single cause to be found.

 Obviously, there is a lot of work to be done to understand this condition before we can offer early effective treatments.

Photo courtesy of Yamane et al