By Dr. W. Gifford Jones
February 4, 1995
Was Vincent van Gogh, the famous Dutch painter really mad, or did he cut off his ear because he suffered from Meniere's Disease? We'll never know the answer to that question. But prior to his death in 1890 Van Gogh was severely depressed. He suffered from vicious, recurring attacks of dizziness, nausea and an intense ringing in the ear.
It's estimated that six million people in North America suffer from this troublesome problem and every year another 110,000 new cases are diagnosed. I'm sure that many of these sufferers, like Van Gogh, wish that they could lop off the annoying ear.
The disease was first described by Prosper Meniere in 1861. It usually strikes between the ages of 40 and 60, and more often men than women.
The typical attack starts with a loud ringing, high©pitched roaring or buzzing sound and a feeling of pressure in one ear. One patient described the sound like the singing of a tea©kettle. This is followed in a few hours by the sudden onset of a whirling sensation and usually a loss of hearing in the affected ear.
The dizziness varies from a simple unsteadiness to a violent churning disorientation. Some patients complain of being thrown out of a chair. Others fall to the ground. A Meniere's attack may last a few minutes or hours and is normally accompanied by nausea and vomiting.
The course of Meniere's disease is unpredictable. Some victims suffer from recurring attacks for weeks or even months. Then the disease may remain dormant for months or years.
Unlike many other diseases there are no simple diagnostic or technological tests for Meniere's Disease. Doctors may order tests such as magnetic resonance imaging (MRI) to rule out neurological brain disorders. But the final diagnosis depends on the clinical picture.
There's another interesting aspect of Meniere's Disease. Nerve deafness, once it's present, never gets better. But the deafness associated with Meniere's Disease fluctuates, at times getting worse and then better.
But generally Meniere's deafness follows a downhill course. Following an attack the deafness may improve, but seldom returns to it's previous acuity. Luckily total deafness is uncommon. Ô 0*0*0* Authorities at Mayo Clinic claim that about 50 per cent of patients with Meniere's Disease eventually notice deafness in the uninvolved ear.
What causes this condition? Many authorities believe that it's related to what's called "endolymphatic hydrops", an accumulation of excess fluid in the inner ear. This swelling in some way triggers the symptoms.
But what causes the excess fluid? It's hoped that an epidemic of dizziness in a small town in Wyoming may help to solve this riddle. Between August and December of 1992 about 40 residents of Thermopolis with a population of 5,000 developed dizziness and nausea.
Epidemiologists from the Centers for Disease Control and Prevention spent three weeks in Thermopolis examining 35 patients suffering from dizziness and 70 healthy patients.
They discovered that about two©thirds of those with dizziness suffered from a flu©like viral illness prior to the onset of dizziness. Moreover over half had noticed a temporary loss of hearing or ringing in the ears during the illness.
Researchers so far have been unable to isolate the suspected virus. But it's believed that one©third of the group may eventually suffer from Meniere's Disease due to a dormant viral infection that set the stage for these symptoms.
Treatment is largely on a trial and error basis. Bed rest is helpful since the sufferer can usually find a position in which the dizziness is less evident. And dramamine can be given to ease the nausea.
A low salt diet and the use of diuretics to decrease fluid accumulation in the inner ear constitute another approach. And the use of sedatives and tranqillizers can be beneficial.
Some nutritionists associate Meniere's Disease with vitamin deficiencies. One treatment consists of giving the patient 50 to 100 milligrams of niacin, a B vitamin 20 minutes before each meal.
There's at least a dozen surgical procedures to treat Meniere's Disease. These control dizziness in about 60 to 90 per cent of cases. But none restore hearing loss or slow down the deafness.
Patients with severe symptoms who are almost deaf may be advised to submit to an operation that destroys all the structures of the inner ear. Or Gentamycin, an antibiotic, can be instilled into the inner ear. This destroys the organ which normally helps us to maintain equilibrium but which is now causing the trouble.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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