Incidence of Hypothyroidism in Meniere's Disease.

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Incidence of Hypothyroidism in Meniere's Disease.

J Clin Diagn Res. 2016 May;10(5):MC01-3

Authors: Santosh UP, Rao MS

Abstract
INTRODUCTION: Meniere's disease is a disorder of the membranous labyrinth of the inner ear manifesting as vertigo, tinnitus, sensory neural hearing loss and aural fullness of known or unknown origin. Some patients may present after years into typical forms. The endocrine disorders, especially hypothyroidism and the factors like inflammation, trauma, otosclerosis, autoimmunity explains the multifactorial causation for the basis of Meniere's disease. Endolymphatic hydrops is the pathologic term named for the defective regulation of endolymph volume with respect to production and absorption. However, hyper production of endolymph cannot be excluded. The cause of Meniers disease is multifactorial so clinical features of repeated attacks of variable duration cannot be explained satisfactorily based on single causation.
AIM: To study the incidence of hypothyroidism in Meniere's disease and to assess the success rate of improvement in subjective symptoms after treatment.
MATERIALS AND METHODS: The study was carried out on total 35 out patients who were clinically diagnosed of Meniere's disease and of these 35 patients, 12 patients were found to have hypothyroidism. All patients with hypothyroidism were treated with oral thyroxin supplements and they were evaluated clinically at 3 weeks, 3 months and 6 months interval for the improvement in subjective symptoms on outpatient basis.
RESULTS: In our study, the subjective improvement of all symptoms was seen in all cases of Meniere's disease with hypothyroidism after 12 weeks of treatment.
CONCLUSION: The improvement in clinical symptoms after treatment demonstrates an association between Meniere's disease and hypothyroidism which was found to be significant. Hence, clinicians should consider screening patients with Meniere disease for thyroid dysfunction who are not already taking supplements.

PMID: 27437251 [PubMed]

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What the ancient Greeks and Romans knew (and did not know) about seasickness.

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What the ancient Greeks and Romans knew (and did not know) about seasickness.

Neurology. 2016 Feb 9;86(6):560-5

Authors: Huppert D, Oldelehr H, Krammling B, Benson J, Brandt T

Abstract
OBJECTIVE: To find and analyze descriptions in ancient Greek and Roman literature that reveal what was known at the time about seasickness.
METHODS: A systematic search was made in the original literature beginning in the Greek period with Homer in ca 800 bc and extending up to Aetios Amidenos in the late Roman period in ca 600 ad.
RESULTS: Rough seas and unpleasant odors were recognized as the major triggers; susceptibility was greater in persons not adapted to sea travel, of a labile mental state, or with anxiety; nausea, emesis, vertigo, anorexia, faintness, apathy, headache, and impending doom were frequently reported symptoms. Preventive and therapeutic measures included habituation to sea travel, looking at stationary contrasts on the coast, fasting or certain diets, inhaling pleasant fragrances, medicinal plants, and ingesting a mixture of wine and wormwood.
CONCLUSION: The triggers, symptoms, and preventive measures of seasickness were well-known in antiquity. The implications for transport of troops and military actions were repeatedly described, e.g., by Livius and Caesar. At that time, the pathophysiologic mechanism was explained by the humoral theory of Empedokles and Aristoteles. Seneca Minor localized the bodily symptoms in various organs such as stomach, gullet, and esophagus, and also attributed them to an imbalance of bile. Recommended medication included ingestion of the plant white hellebore, a violent gastrointestinal poison. This remedy contains various alkaloids but not scopolamine, which today is the most effective anti-motion-sickness drug.

PMID: 26857952 [PubMed - indexed for MEDLINE]

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[Cholesteatoma must be considered in case of recurrent ear discharge].

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[Cholesteatoma must be considered in case of recurrent ear discharge].

Ugeskr Laeger. 2014 Dec 15;176(51)

Authors: Fjaeldstad A, Ovesen T, Britze A

Abstract
This case report describes delayed cholesteatoma detection in a six-year-old boy with recurrent ear discharge since the age of two with no history of vertigo. Removal of the cholesteatoma disclosed facial nerve dehiscence, exposure of the sigmoid sinus and the dura covering the posterior fossa, as well as two fistulas to the semicircular canals. Erosive breaches of extra- to intracranial barriers entail a risk of developing severe intracranial infections, cerebrospinal fluid leakage, irreversible deafness, and loss of vestibular function. Therefore, early diagnosis of cholesteatoma is of utmost importance.

PMID: 25534219 [PubMed - indexed for MEDLINE]

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