Lermoyez syndrome
| Classification according to ICD-10 | |
|---|---|
| H81.3 | Other peripheral vertigo Lermoyez syndrome |
| ICD-10 online (WHO version 2019) | |
When Lermoyez syndrome (after Marcel Lermoyez , 1858-1929) is a rare disease of the inner ear with anfallsartigem character. Some authors regard it as a special form of Meniere's disease and not as an independent disease.
Symptoms
The symptoms are similar to Menière's disease . Patients suffer during an attack by vertigo , some with tinnitus . An already existing hearing loss improves in the acute attack. In 1919 Lermoyez described Menière patients in whom the typical symptoms appeared in what is known as the reverse order : noises in the ears and hearing loss occurred before the symptoms of equilibrium. The initial hearing loss increases until severe dizziness sets in. In a short time, however, the hearing recovers.
root cause
The exact cause of the disease is not known. The inner ear consists on the one hand of the balance organ and on the other hand of the cochlea . In both structures there are two spaces separated from each other by thin membranes. One room is filled with low-potassium (perilymph), the other with potassium-rich liquid (endolymph). It is assumed for Lermoyez syndrome as for Menière's disease that these two fluids can mix in an acute attack. This then affects both hearing and balance.
In addition, other causes such as allergies or disorders of the spine that affect the nerves of the sympathetic nervous system are also discussed.
Diagnosis
Lermoyez syndrome is diagnosed clinically and after excluding other causes. So far, individual patient cases have been published.
Ear microscopy shows normal findings in the ear canal and eardrum . The examinations of the middle ear also show no pathologies .
A hearing impairment can be determined by a tone audiogram . In an acute attack, abnormal eye movement ( nystagmus ) occurs due to the dysfunction of the organ of equilibrium . A computed tomography can determine anatomical deformities of the inner ear. A magnetic resonance imaging (MRI) includes changes made at the hearing and balance nerve. The function of the equilibrium organ can be checked more precisely by checking the balance by rinsing the ears with cold and warm water. This examination is difficult to carry out in an acute attack.
therapy
A specific therapy is currently not known. In the case of severe dizziness with nausea and vomiting, treatment is symptomatic. z. B. Betahistine is given over a long period of time to suppress dizziness. If dizzy spells are in the foreground with poor hearing, the balance organ can be switched off with medication ( gentamicin ) or the balance nerve can be switched off by an operation.
Attempts at therapy with antihistamines are also described.
literature
- M. Lermoyez: La Vertige qui fait entendre (angiospasm labyrinthique). La presse médicale, Paris 1919, 27, pp. 1-3. (also in: Annales des maladies des oreilles et du larynx. 1929, 48, pp. 575–583)
- HG Kempf, K. Jahnke, Lermoyez syndrome. Clinical aspects and follow-up. In: ENT. 1989 Jul; 37 (7), pp. 276-280. PMID 2759873
