Author Topic: 150 years of Meniere ...  (Read 874 times)

Offline HelKombi

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150 years of Meniere ...
« on: Jan 28 2011, 12:32 PM »
... and so far behind!!

Found this article on the web, as I am the curator in for the Meniere topic, and thought of sharing it with fellow Menieres.

"We were inspired by the 150-year anniversary of the first description of Meniere's disease by Prosper Ménière to evaluate this review for F1000. This article provides an excellent overview on the anatomy and physiology of Meniere's disease as well as its patho-physiological hypotheses. According to a very good recent study and overview, Meniere's disease -- an as yet poorly understood syndrome -- seems to have a lifetime prevalence of about 0.2% {1}. Along with headache and dizziness, vertigo is among the commonest symptoms with which patients present to general practitioners. Moreover, Meniere's disease is the second most common cause of a peripheral vestibular deficit {2}. One should therefore suspect that physicians in general would be familiar with this disease; however, experience shows that patients often undergo an odyssey of visits before the correct diagnosis is established.

Since Schuknecht's seminal histological studies on the membranous inner ear, the rupture theory has persisted as the prevailing explanation of Meniere's disease for most general physicians. Recent research, however, has cast doubt on this theory.

In this article, Gibson outlines possible other mechanisms with an emphasis on the drainage theory, first proposed by the author himself 20 years ago {3}. Briefly, the drainage theory suggests abnormal endolymph draining from the cochlear duct causing the vertigo crises.

In our opinion the most important take-home message, however, is the emphasis on the awareness that Meniere's disease is probably not a single disease entity but rather a syndrome with several different pathologic conditions resulting in the same symptom complex. Gibson therefore proposes that using the term Meniere's syndrome might be more precise.

In summary, this review offers a good, easy-to-read and comprehensible overview about several important hallmarks that should be known even by a general practitioner. References:
{1} Harris and Alexander, Audiol Neurootol 2010, 15:318-22 [PMID:20173319].
{2} Brandt et al., "Vertigo and dizziness common complaints." Springer: London, 2005 [ISBN:978-1852338145].
{3} Gibson and Arenberg, "The circulation of endolymph and a new theory of the attacks occurring in Meniere's disease." In: "Proceedings of The Third International Inner Ear Symposium." Arenberg IK (ed) Amsterdam: Kugler & Ghedini, 1991:17-22.
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