Data Sheet 3_Changes in symptom pattern in Meniere's disease by duration: the need for comprehensive management.pdf

PurposeThis retrospective study aimed to analyze the symptom profile of Meniere's disease (MD) patients, particularly focusing on the cessation of episodic vertigo and the disease's longitudinal course and the impact of major symptoms on quality of life (QoL).MethodsThe study employed a cross-sectional design and was conducted on 365 out of 560 individuals with definite MD from the Finnish Vestibular and Meniere Federation, utilizing an internet-based questionnaire. Participants were surveyed on vertigo attacks, vestibular drop attacks (VDA), balance issues, selective cognitive complaints, hearing loss, and their effects on overall quality of life (QoL). The study population comprised 79.5% females and 20.5% males, with a mean age of 63 years and an average disease duration of 15.2 years.ResultsThe onset of MD was characterized by simultaneous hearing loss, vertigo, and tinnitus in 38% of participants. There was a significant delay in diagnosis for many, with 20% experiencing a delay of over 5 years. The frequency and duration of vertigo attacks generally decreased over time, with attacks becoming shorter and less severe as the disease progressed. Spontaneous remission from episodic vertigo occurred in 34% of participants variably throughout the course of MD. Of the participants 65.5% reported balance issues, and 34% experienced mild VDAs, with severe falls occurring in 10%. VDAs were more common with longer disease duration. Bilateral hearing loss developed in 34.5% of participants over the long term, with a higher risk associated with younger onset age, migraines, and family history of MD. Fatigue, anxiety, and depression were prevalent, particularly among younger participants. Cognitive impairments were linked to the severity of these symptoms and the presence of constant dizziness. QoL was significantly lower among participants with constant dizziness, with factors like fatigue, depression, VDA, and hearing loss contributing to this reduction.ConclusionsThe study highlights the complexity of MD. While vertigo may spontaneously remit, other symptoms such as VDAs, balance issues, cognitive complaints, and hearing loss often persist and worsen over time. Assessing MD solely on primary symptoms like vertigo and hearing loss is insufficient; a comprehensive evaluation is necessary for effective management.

本研究旨在回顾性分析梅尼埃病（MD）患者的症状特征，特别是针对阵发性眩晕的终止、疾病的纵向进程以及对主要症状对生活质量（QoL）的影响。研究采用横断面设计，对来自芬兰前庭和梅尼埃联合会的560名确诊为MD的个体中的365人进行了调查，采用基于互联网的调查问卷。参与者被调查了眩晕发作、前庭下降发作（VDA）、平衡问题、选择性认知投诉、听力损失及其对整体生活质量（QoL）的影响。研究人群包括79.5%的女性和20.5%的男性，平均年龄为63岁，平均疾病持续时间为15.2年。MD的发病特征为38%的参与者同时出现听力损失、眩晕和耳鸣。许多患者诊断延迟明显，其中20%的患者诊断延迟超过5年。随着疾病的发展，眩晕发作的频率和持续时间通常逐渐减少，发作变得更加短暂和轻微。34%的参与者在MD病程中不同阶段自发缓解了阵发性眩晕。65.5%的参与者报告有平衡问题，34%的参与者经历了轻微的VDA，10%的参与者发生了严重的跌倒。VDA在疾病持续时间较长的情况下更为常见。长期来看，34.5%的参与者出现了双侧听力损失，与发病年龄较轻、偏头痛和MD家族史相关的高风险有关。疲劳、焦虑和抑郁在年轻参与者中尤为普遍。认知障碍与这些症状的严重程度以及持续眩晕的存在有关。持续眩晕的参与者的生活质量显著降低，疲劳、抑郁、VDA和听力损失等因素导致了这种降低。结论：本研究突显了MD的复杂性。虽然眩晕可能自发缓解，但其他症状如VDA、平衡问题、认知投诉和听力损失往往持续并随时间恶化。仅基于眩晕和听力损失等主要症状评估MD是不够的；为了有效管理，需要进行全面的评估。