by Lori Solomon

Meniere’s disease (MD) shows a complex disease course, with initial symptoms decreasing and others persisting and worsening over time, according to a study published online Nov. 7 in Frontiers in Neurology.

Ilmari Pyykko, M.D., from Tampere University in Finland, and colleagues analyzed the symptom profile of MD with a focus on the cessation of episodic vertigo, the longitudinal disease course, and the impact of major symptoms on quality of life (QoL). The analysis included 365 patients with definite MD.

The researchers found that the onset of MD was characterized by simultaneous hearing loss, vertigo, and tinnitus in 38% of participants. Many experienced a significant delay in diagnosis, with 20% experiencing a delay of more than five years. Over time, the frequency and duration of vertigo attacks generally decreased, with attacks becoming shorter and less severe as the disease progressed. One-third of patients (34%) had spontaneous remission from episodic vertigo.

Additionally, 65.5% of participants reported balance issues, 34% mild vestibular drop attacks (VDAs), and 10% severe falls. Longer disease duration was associated with VDAs. More than one-third of patients (34.5%) developed bilateral hearing loss, with a higher risk associated with younger age at onset, migraines, and family history of MD. Participants with constant dizziness and with factors like fatigue, depression, VDA, and hearing loss experienced lower QoL.

“Assessing MD solely on primary symptoms like vertigo and hearing loss is insufficient; a comprehensive evaluation is necessary for effective management,” the authors write.

More information: Ilmari Pyykkö et al, Changes in symptom pattern in Meniere’s disease by duration: the need for comprehensive management, Frontiers in Neurology (2024). DOI: 10.3389/fneur.2024.1496384

Journal information:Frontiers in Neurology

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