STAGES OF MENIERE'S DISEASE
Stage 1
In the early stages of Meniere's disease, vertigo is usually the predominant symptom. Complete recovery occurs after each attack and by the time the person presents for diagnostic tests, the ear has returned to normal. The condition may start with sudden attacks of vertigo that are disabling. This is a common problem and may be halted by avoidance of excessive dietary intake of salt.
By making a correct diagnosis early in the progression of the disease the long term effects of Meniere's may be lessened by making appropriate life style and dietary changes. About 50% of people with stage 1 Meniere's will progress to stage 2.
When the main symptom is muffled hearing the condition may be mistaken for blocked ventilation of the middle ear. When vertigo is the predominant symptom, the doctor may mistake the diagnosis for a viral illness of the inner ear (viral labyrinthitis). At this stage the diagnosis may only be made by careful questioning about the other symptoms. Patient history is one of the most important factors in making the diagnosis; however, often the vertigo is so distressing that many people fail to notice changes in hearing, or even tinnitus.
Stage 2
During this stage the symptoms are more florid and more likely to include all the features of the syndrome. Symptoms can be referred to as "classical" and it is easier to make the diagnosis. Hearing fluctuates but never returns to normal levels. Tinnitus increases with attacks, and becomes continuous. The feeling of aural fullness can be worse before or during an attack.
If the person is lucky enough to have reasonable warning of an impending attack, they can take medication to try to avert it. Unfortunately, not all people have enough warning to be able to do so.
The attacks of vertigo tend to occur in clusters and may be severe enough to affect the person's lifestyle. However, between a series of attacks there can be periods of remission, which may vary from a few weeks to several years. About 80% of people with stage 2 Meniere's will progress to Stage 3.
Stage 3
This stage may be referred to as 'burnt out Meniere's'. The hearing is affected severely and there is no more fluctuation as Meniere's has destroyed the hair cells of the inner ear. However although the person may feel the hearing is useless, it is rare for an ear to become completely deaf - usually about 50% of hearing remains.
If Meniere's is present in both ears, hearing can be utilized by wearing hearing aids, although there are distortions, such as abnormal sensations of loudness, difficulty in tuning and marked problems when there is background noise. Attacks of vertigo occur much less frequently and eventually cease. Usually people no longer vomit, the nausea and dizziness is mild - only lasting a few minutes.
Unfortunately, when the ear has lost about 50% of its balancing function, attacks of dizziness may be replaced by a more persistent feeling of unsteadiness which is more noticeable in the dark, or in places where the person cannot use vision to orientate themselves. For instance, it may be difficult to walk in crowds, ride on escalators or even walk through a busy supermarket.
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GENERAL HEALTH
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