Why Do People Get Mnires Disease
Many theories exist about what happens to cause Ménières disease, but no definite answers are available. Some researchers think that Ménières disease is the result of constrictions in blood vessels similar to those that cause migraine headaches. Others think Ménières disease could be a consequence of viral infections, allergies, or autoimmune reactions. Because Ménières disease appears to run in families, it could also be the result of genetic variations that cause abnormalities in the volume or regulation of endolymph fluid.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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Falls And Parkinson’s Disease
A loss of balance often resulting in falling affects many with Parkinsons. This is due in part to general motor dysfunction caused by the disorder. Falling can depend on each persons symptoms and how they respond to medication. This should be monitored for any pattern noted at the time of these changes or fluctuations.5 Syncope is one of the most commonly overlooked causes of dizziness in people with Parkinsons.2
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How can I prevent dizziness?
Tuesday September 04, 2012
Dizziness can have multiple causes in Parkinson’s. Most common, is low blood pressure, specifically a drop in blood pressure with standing a condition caused orthostatic hypotension. People of use the term dizziness to describe many different problems. The term dizziness is also used to describe a sense of imbalance when standing or walking, vertigo or sense of motion caused by inner ear or vestibular problems and a lack of mental clarity.
Low blood pressure can cause dizziness, ‘passing out’, fatigue, walking problems, and thinking problems.
Dizziness due to orthostatic hypotension can be treated. Most of these treatments work by increasing the volume of blood in your circulatory system, increasing blood pressure and optimizing heart function.
Monique L. Giroux, MD
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What Is Mnires Disease
Ménières disease is a disorder of the inner ear that causes severe dizziness , ringing in the ears , hearing loss, and a feeling of fullness or congestion in the ear. Ménières disease usually affects only one ear.
Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some people with Ménières disease have vertigo so extreme that they lose their balance and fall. These episodes are called drop attacks.Ménières disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age. The National Institute on Deafness and Other Communication Disorders estimates that approximately 615,000 individuals in the United States are currently diagnosed with Ménières disease and that 45,500 cases are newly diagnosed each year.
The Heart Of The Matter: Cardiovascular Effects Of Parkinsons Disease
It has long been understood that Parkinsons disease does not just cause movement symptoms, but also causes a litany of non-motor symptoms with effects throughout the body. One of the organ systems that is affected is the cardiac system, encompassing the heart, as well as the major and minor blood vessels. I received this topic as a suggestion from a blog reader and we will be discussing this important issue today. Please feel free to suggest your own blog topic.
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What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
Cognitive And Psychiatric Symptoms
- depression and anxiety
- mild cognitive impairment slight memory problems and problems with activities that require planning and organisation
- dementia a group of symptoms, including more severe memory problems, personality changes, seeing things that are not there and believing things that are not true
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Understanding The Neurologic Control Of The Cardiac System
Before we explore this issue, lets first learn a bit about the autonomic nervous system and about the cardiac systems place within it. The ANS is part of the peripheral nervous system, a network of nerves throughout the body. The ANS exerts control over functions that are not under conscious direction such as respiration, heart function, blood pressure, digestion, urination, sexual function, pupillary response, and much more. The ANS is further subdivided into the parasympathetic nervous system and the sympathetic nervous system. Both the parasympathetic and sympathetic nervous systems regulate most major organs. Often, they have opposite effects, with the sympathetic nervous system activating a system and the parasympathetic system calming it down.
One of the systems controlled by the ANS is cardiac regulation. Blood pressure sensors, known as baroreceptors, reside in the heart as well as in the carotid artery, the major artery in the neck. If the baroreceptors sense a change in the blood pressure, a signal is sent to particular areas in the brain. From there, the autonomic nervous system sends signals to the heart to control heart rate and cardiac output. Signals are also sent to the blood vessels to change the size of their diameter, thereby regulating blood pressure.
Late Complications Of Parkinson’s Disease
Patients with PD respond to levodopa almost immediately. However, 20 to 50% of patients will develop motor fluctuations or dyskinesias within 5 years of starting levodopa therapy. Response fluctuations consist of a mixture of “wearing-off” phenomenon, “on” dyskinesias , “Diphasic dyskinesias” , and “off” dystonia .
Wearing off can be managed by decreasing the dosing interval, switching to a longer acting product, or by adding or increasing the dose of dopamine agonist. On-off effects are harder to manage. The addition of a direct dopamine agonist or switching to a slow acting dopamine preparation may reduce the frequency of dyskinesias and on/off events. Pramipexole, as initial therapy compared to levodopa, reduces the risk of developing complications by about 55%, but it is not as effective as Levodopa and has some adverse affects . COMT inhibitors may smooth smooth out the peaks/troughs of dopamine and reduce fluctuation.
Psychiatric adverse effects include psychosis, confusion, agitation, hallucinations and delusions. These can be treated by decreasing dopamine medication, reducing or discontinuing anticholinergics, amantadine or selegiline, or by using clozipine at doses of 6.25 to 50 mg/d .
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Common Causes Of Dizziness And Vertigo In Parkinsons And How To Treat Them:
In people with early Parkinsons disease , the dizziness has in many cases linked to a lower Montreal Cognitive Assessment score raising the possibility that dizziness may be a non-movement symptom associated with cognitive decline .
Dizziness or vertigo can be tied to many causes and is not unique to Parkinsons. Symptoms can be caused by medications, low blood pressure, anxiety, cold, flu, dehydration, heart conditions and more. Tell your doctor immediately if you regularly experience dizziness or vertigo.
Page reviewed by Dr. Michael S. Okun, Parkinsons Foundation Medical Director, Professor and Chair, Department of Neurology, Executive Director of the Fixel Institute for Neurological Diseases a Parkinson’s Foundation Center of Excellence.
What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
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How Does A Doctor Diagnose Mnires Disease
Ménières disease is most often diagnosed and treated by an otolaryngologist . However, there is no definitive test or single symptom that a doctor can use to make the diagnosis. Diagnosis is based upon your medical history and the presence of:
- Two or more episodes of vertigo lasting at least 20 minutes each
- Tinnitus
- Temporary hearing loss
- A feeling of fullness in the ear
Some doctors will perform a hearing test to establish the extent of hearing loss caused by Ménières disease. To rule out other diseases, a doctor also might request magnetic resonance imaging or computed tomography scans of the brain.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
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How Parkinsons Disease Affects The Autonomic Nervous System And The Heart
In PD, there are two major reasons why the automatic control of the cardiac system is impaired. First, areas of the brain that control this system often contain Lewy bodies and have undergone neurodegeneration. In addition, the autonomic nervous system itself is directly affected by Lewy body-like accumulations and neurodegeneration. This means, when the baroreceptors in the heart and carotid artery sense a drop in blood pressure and try to generate a signal to the heart and blood vessels to increase the blood pressure, the message may not get through. This results in neurogenic orthostatic hypotension , or drops in blood pressure upon standing due to autonomic nervous system dysfunction. There are no medications that can cure nOH by restoring the autonomic nervous system in PD. nOH however, can be treated. Read more about nOH and its treatments here.
Structural problems of the heart such as coronary artery disease or cardiomyopathy are not thought to be part of the pathology of PD, although of course, could co-exist with PD.
Moving Around Your Home
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Think about comfortable supportive footwear. For example, if you wear slippers make sure they fit well and have a back to them .
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Make sure the floor in your home is uncluttered so that you can move around easily and are less likely to trip. Move any loose rugs that could cause you to fall over.
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If you are unsteady on your feet around the house, there is a range of equipment that can help. For example, grab rails give you something to hold and steady yourself with. These can be handy in tricky areas such as the shower, the bathroom, or where there are steps.
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Dizziness And Vertigo In Parkinsons
Dizziness and vertigo are not unique to Parkinsons disease .3 There can be multiple causes and determining an effective treatment depends on good reporting of the symptoms and the ability to identify a cause. Additionally, symptoms may be less notable in the early stages of Parkinsons.3 As with most aspects of Parkinsons, the experience of symptoms is unique you may not ever experience these.
Dizziness Caused By Parkinsons Disease
Parkinsons disease is a neurological condition that affects a persons ability to move. Research has linked the dizziness associated with Parkinsons to cerebral hypoperfusion. In laymans terms, this means not enough blood is getting to the brain. What can cause a reduction in blood flow to the brain?
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What Are The Primary Motor Symptoms Of Parkinsons Disease
There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.
It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.
Tremors
Rigidity
Bradykinesia
Postural Instability
Walking or Gait Difficulties
Dystonia
Vocal Symptoms
How Is Orthostatic Hypotension Treated
Droxidopa . fludrocortisone , or midodrine capsules are approved for the treatment of orthostatic hypotension. Common side effects include headache, dizziness, nausea, high blood pressure, and fatigue.
Another approach in treating orthostatic hypotension is to decrease the pooling of blood in the legs with the use of special stockings called compression stockings. These tight stockings “compress” the veins in the legs, helping to reduce swelling and increase blood flow. There are a number of companies that make these stockings in a wide variety of sizes, and they usually can be found at stores that sell medical supplies, as well as at some pharmacies.
You should wear these stockings when you are up and about. You do not need to wear them when you are in bed. Further, it is recommended that you put the stockings on first thing in the morning while in bed and before getting up for your daily activities. It is important that you do not let the stockings bunch, gather, or roll, since this can compress the veins too much and could harm circulation. You should always watch for signs of decreased circulation, which could include discoloration of the skin, as well as pain or cramping, and numbness of the lower legs and feet.
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Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo is a sense of spinning when turning in bed. It may last only a few seconds but can be scary or make you feel nauseated.2 A doctor can diagnose BPPV by performing a physical examination using a diagnostic maneuver such as the Dix Hallpike. To improve this problem there are exercises to do at home, such as the Epley or Semont maneuvers, that can help resolve and restore balance in your ear. Its achieved by putting your head in different positions, which moves crystal debris out of the semicircular canal of the ear and resolves the symptoms of vertigo.
Stress Anxiety And Depression
Depression and anxiety are often mistakenly thought of as purely psychological issues, where in fact they have real physical effects on the functioning of our body processes. A sudden flare up in this area , excessive exposure to stress , or prolonged, unmanaged anxiety and depression, can all lead to irregular nervous system activity which can produce various symptoms of dizziness.
These causes are commonly overlooked as both patients and medical providers can dismiss this as a legitimate source of dizziness. However, proper treatment can be highly effective in managing and eliminating your symptoms.
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