Edited by Brian P. Pace, MA, Assistant Editor.
BY JAMES M. BROWN, M.D. AND JUDSON DALAND, M.D.
The employment of a term as indefinite as "Meniere's Disease" is now
generally held to be, in giving title to the subject to which I ask your attention,
may call for some explanation or apology, for quoting the words of Sir Wm.
B. Dalby: "The term serves more frequently to mark ignorance of the lesion
which occasions a series of symptoms, often analogous, but which are under
the influence of very different causes. . . . " Until we know the exact pathology
and are able to separate other analogous diseases with which it may be confounded,
it is wiser to hold to the name "Meniere's disease." Faintness, deafness and
vertigo were the symptoms that especially engrossed Meniere's attention, and
of these the latter seemed most momentous, and his investigations led him
to believe that the lesions which produced it were restricted to the semi-circular
canals. . . . Politzer and Lucae both report instances in which the semi-circular
canals were absent or, by trauma, filled with blood, and yet the patients
did not suffer from any disturbance of equilibrium. Gradenigo, Moos and Burnett
believe the vertigo to be chiefly due to an extension to the labyrinth of
a chronic catarrhal affection of the middle ear. Steiner of Cologne believes
that the vertiginous symptoms result from lesions within the brain or its
membranes, causing alterations in pressure. . . . It may be caused by organic
changes in the perceptive mechanism, or secondary to diseases of the conductive
apparatus, or to blood conditions, or circulatory disturbances, to certain
diatheses, or may be wholly reflex. . . . Bezold has collected and reports
forty-six cases of necrosis of the labyrinth, and notes that only twelve showed
symptoms of vertigo. Mackenzie says it is due to the effect of irritation
of the terminations of the vestibular nerve. . . . And so I might multiply
authors and recount opinions and cases, but enough has been given to show
that we are dealing with an intricate and imperfectly understood disease,
one whose manifestations seem entirely out of proportion to its lesions.
MENIERE'S DISEASE, WITH REPORT OF A CASE.. JAMA. 1998;279(8):578F. doi:10.1001/jama.279.8.578