Psychosomatic Medicine 15:127-139 (1953)
© 1953 American Psychosomatic Society

Psychophysiological Factors in Ménière's Disease

¹ Departments of Otolaryngology (E.P.F., Jr.) and Psychiatry (A.Z.), College of Physicians and Surgeons, Columbia University, New York

Psychiatric study of 23 patients with Ménière's disease demonstrates that the paroxysmal attacks of vertigo and often the onset of tinnitus and deafness can definitely be related to life stress situations. There is apparently a fundamental emotional predisposition but the first acute attack of vertigo, as well as most subsequent attacks, tends to follow an explosive outburst or a damming-up of tension in an underlying intolerable situation.

The red blood cell flow as observed with the high powers of a slit lamp in the conjunctival vessels of these patients before and especially immediately after these attacks resembles that seen in cats subjected to intravenous epinephrin or cervical sympathetic stimulation. This has been observed in most of the patients and experimentally produced by psychic stimulation in 2. There is slowing of the circulation with lumping of blood such as has been called "blood sludge." Occasionally there are microscopic hemorrhages. The conclusion is that the clumps of blood stick in the tiny vessels of the labyrinth where they produce local disturbances which in turn produce symptoms and eventually, if the vascular pathology persists, the picture of labyrinthine hydrops characteristic of advanced Ménière's disease.