15.10.1 Introduction
(i) This is a disease of the inner ear characterised by attacks of vertigo (dizziness), nausea and vomiting, associated with tinnitus (ringing in the ear) and increasing deafness. It can occur at any age but usually starts in the 4th or 5th decades.
(ii) Although attacks may be extremely incapacitating at the time, it is uncommon for them to last for more than a few hours at a time or to occur frequently for more than a few weeks at a time. The overall care and mobility needs will usually be slight.
(iii) The first symptoms usually noticed are deafness and tinnitus; but there may be vague unsteadiness, hearing difficulties, slight nausea or a feeling of pressure in the head. These normally affect one ear only but may progress to involve both. The attacks of vertigo may begin abruptly but are normally preceded by an intensification of the tinnitus. This or other warnings usually gives the sufferer time to sit or lie down so falls are unusual. There is usually no precipitating event for the attacks and they may occur during sleep.
(iv) The attacks usually last between 15 minutes and 2 hours during which time it is unusual for there to be any need for attention or supervision. The attacks can be frightening so reassurance may be necessary, but the person is unlikely to be in any danger. There may be long periods of freedom from attacks and in those cases that do progress the attacks may cease or eventually diminish with increasing deafness. Some persons may be left with some disturbance of balance.
15.10.2 Care Needs and Mobility Considerations
Because the attacks usually occur in clusters with weeks or months in between, any care and mobility needs that may arise are intermittent and short-lived. At most there may be a need for help for a few weeks at a time. For the periods free from attacks there will be no attendance need. The person usually gets warning of an attack. The affected person would not usually have any mobility problems.
15.10.3 Further Evidence
If there appear to be care and mobility needs in excess of those mentioned above, a report should be obtained from the GP or any hospital the person is attending.