The clinical symptoms that are used as diagnostic criteria for Meniere's Disease are: (1) Tinnitus. (2) Vertigo. (3) Plugged ears. (4) Hearing loss. These are the basic 4 symptoms of Meniere's Disease.
The sequence of events is dynamic and variable.
Typically there are also symptoms of fear, anxiety, irritability, despair and decreased ability to do a productive work. An important complication of meniere's disease is divorce.
Usually it is Uni-lateral. A patient may complain on a sensation of plugged ear on his left side.
The Ear Nose and Throat specialist is doing Otoscopy and finds cerumen in the auditory canal of his external ear.
After the expert removes the cerumen, the patient reports of relieve.
Later (after few days, few weeks or few months) the patient is coming again complaining of uni-lateral tinnitus.
The tinnitus is usually a fixed sound with ups and downs during the day.
Some of the lucky patients report of relieve when there is a masking sound.
Hearing loss is a late complication of the disease.
There are patients who come to the emergency room with a complaint of vertigo.
They report of a sensation that their head is spinning or the room is revolving and stimulating them to have nausea, with or without vomiting. This dramatic picture may be followed by more attacks that affects the equilibrium system.
The other symptoms, such as tinnitus, plugged ears and hearing loss, may come later.
Mr. Joao Rolo Brito Carlos who is a musician from Portugal tells about his vertigo and hyperacusis.
In the pre treatment phase of his disease he could not continue to work in the Symphonic Orchestra of Portugal because of his severe hyperacusis.
The Israeli musician Mr. Backman Amir also had hyperacusis, but it came together with tinnitus.
Most of the experts are waiting to see if the patient is suffering from all the 4 symptoms. Some of the experts are ready to tell the patient that most probably these are the first Meniere's Disease Symptoms.
There are patients who have a different clinical picture every week.
Although all the symptoms are present continuously, the worst symptoms are hiding the weaker symptoms in such a way that the sufferer is aware of the most severe and anxiety provoking symptoms.
The severely affected system determines the clinical picture.
When the vestibular system is irritated, the dominant symptoms can be vertigo, dizziness or unsteadiness. Active pathology in the auditory system results in tinnitus, hearing loss and hyperacusis.
The attacks of vertigo and unsteadiness between the attacks may come and go. The cycle may vary from several attacks during one month and than a resting period for a year or two, and a more severe clinical picture.
The unlucky patients may have continues attacks. Sometimes almost every day.
The tinnitus may have ups and downs. The loud tinnitus may come for few seconds, but it may be very threatening. Others may complain of longer intervals of continuous loud tinnitus coupled with hearing loss in the affected ear.
Hyperacusis is a sensitivity to loud sound. It is a combination of biological and psychological mechanisms. The biological part is a result of the hypersensitivity of the auditory system to strong noises.
The psychological part is the fear of deterioration in the symptoms of tinnitus and hearing loss due to the noise exposure.
Plugged ears or fullness in the ears is an independent symptom, and may mimic the clinical picture of Eustachian tube dysfunction, infection in the middle ear (acute otitis media, chronic otitis media, serous otitis media), cholesteatoma and acoustic neuroma.
A complaint of uni-lateral hearing loss is the typical symptom in a patient who is suffering from active Meniere's disease. About one third to one half of those who start with a clinical picture of Meniere's disease recover spontaneously.
The audiograms of the patients can be traced to the beginning of the disease and show a progressive course in the functioning of one ear. The low frequencies are associated with hearing of human voices and have a lot of importance in the decision of starting to use a hearing aid.
Early phase of the right ear
In the range of 250–500 Hrtz there is a low-tone sensorineural hearing loss of the right ear.
Middle phase of the right ear
Hearing is reduced at all frequencies. High and low frequencies of the right ear are more affected. The left ear starts to show hearing loss.
Late stage of the right ear
Advanced hearing loss in the right side: Hearing deterioration on the right side ear. The left ear starts to show involvement of the disease.
My friend (who started as my patient), Dr. Arie Yagoda, started as a patient that his medical experts of Ear Nose and Throat did not tell him that he is suffering from Meniere's Disease. He came to me in the phase that Tinnitus was the dominant symptom, but when the plugged ears bothered him very much, he was referred to unnecessary surgical procedure in his ears.
Mr. Van Romondt Mark suffered from few attacks of vertigo and prolonged tinnitus. He could not find effective medical treatment near home in Aruba, and came to Israel. In his video clip he is telling briefly about his medical condition and his cure.
Mrs. Anatt Cohen suffered long time from Meniere's Disease and finally she is cured. She was video-taped, and tells more details about her symptoms.
Mrs Shachar Lidia suffered from vertigo and tinnitus. Her husband was a good sales man, but in spite of that their shop collapsed. She tried to save money by discontinuation of her treatment and try injections to her ears. The result of it was very bad, and she came back to my clinic. Now she feels much better, but still have financial problems that determines the dose of capsules that she takes.