Meniere's Disease 17.docx - Scenario: Sonia is a...

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Scenario:Sonia is a 63-year-old who has lived with vertigo for most of her adult life. Her vertigo is sosevere that she is unable to lay down on her right side without experiencing severe dizziness.During episodes of severe vertigo, the symptoms dramatically worsen whenever Sonia opensher eyes. Sonia did not typically experience headaches, nausea, or vomiting, but this changedone day when she slipped getting out of the shower and hit her head. Since this fall, Sonia hadtwo severe vertigo episodes where she experienced nausea and vomiting, prompting her to goto the emergency department. When asked if there was anything that made her symptomsworse, Sonia mentioned that her hearing was worse and her ears felt “stuffy” during the spring,but she had always thought this had to do with her seasonal allergies. Sonia's hearing hadgotten worse and she mentioned hearing a faint ringing in her ears but attributed this to age.The doctor suspects that Sonia has Meniere’s disease and refers her to an ear, nose, and throatspecialist for a caloric test. In the meantime, she is provided with vestibular suppressants andanti-emetics and sent home to rest.Vertigo: The BasicsVertigo is a type of dizziness that tends to be episodic and related to the vestibularsystem of the inner ear. It can be caused and exacerbated by several factors, including ear
infections, migraine headaches, or Meniere’s disease, an illness involving fluid build-up in theinner ear. Symptoms of vertigo - dizziness, loss of balance, and nausea are most common - canbe brought about by movement of the head or rapid movement occurring around one’s head.The vestibular system essentially works as a level to tell the brain about the head’sorientation relative to the rest of the world. It consists of several fluid-filled canals (semi-circularcanals) in the inner ear, which are filled with hair cells that detect the movement of the fluidwithin the canal caused by gravity or body movement (Howarth, 2020). This information allowsthe brain to determine and optimize the orientation of the body to its surroundings. The canalsare organized at approximately 90°degrees to each other to detect movement in all directions.The vestibular system also includes the otolith organs, which function similarly except they aremore sensitive to acceleration and tilting of the head (Dingman, 2015). They have a membraneabove the fluid layer with calcium carbonate crystals within it; one type of vertigo, benignparoxysmal positional vertigo (BPPV), occurs if these crystals become displaced. Inflammationof the inner ear also affects the perception and transmission of vestibular information, as canhappen with ear infections, which may trigger vertigo. Meniere’s disease is believed to causevertigo by excess fluid putting pressure on the canals and disrupting (or going against thenormal calibration of) the flow of the fluid (Mayo Clinic, 2020).

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Term
Fall
Professor
Maureen
Tags
Sonia

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