Docent Mikael Karlberg is consultant physician at the ENT clinic at Skånes University Hospital Lund and at the ENT clinic Lasarettet Trelleborg. He is also connected to the specialist doctors in Lund and Dizziness Centre Skåne.
One in four senior citizens in Sweden suffers from dizziness.
Mikael Karlberg talks about his work, which is largely devoted to
Patients with dizziness and balance disorders.
– Dizziness is a very common problem for the public. Every fourth
pensioner, as well as every third woman of working age, suffer from dizziness of greater or lesser severity. Dizziness accounts for three percent of visits to hospital emergency services, equivalent to 75,000 visits a year!
– How many of the dizziness patients in Sweden have Meniere’s disease, there is actually no exact figure. But among other things based on comparisons with Finland, which has more reliable statistics, we expect 0.5 percent of the population, i.e. around 50,000 people in Sweden, to have Menière’s disease.
– Diagnosis of Meniére is not easy to do and research is very difficult
to perform. If clinical studies do not take sufficient care about the fact that the disease comes in temporary spells, it can lead to erroneous conclusions.
I see about 20 Meniére patients a week. The treatment varies; Almost all we are dealing with are processes. Let me quote my own website:
When I meet a patient with Meniere’s disease for the first time, my most important message is always:
- «If the dizziness attacks get too bad and come too often, we have scientific evidence that we have treatment that can make you free from the attacks!»
- «Unfortunately, we have no scientific support for anything we find to affect your hearing loss or tinnitus!»
- My third message is: «The lack of scientific support does not prevent me from trying out different treatments! I’m your doctor and take care of you until we find the right treatment for you! «
Mikael Karlberg has experience with antisecretory factor.
– AF is included in my treatment arsenal, but not always as a first line treatment. I first try to insert a tympanostomy tube. It may cause discomfort one week after insertion, but then the patient usually gets better. I am prescribing SPC Flakes every now and then. It has a good effect on some patients, but not all. The effect, if it comes, can only enter after some time. The patient giving up on treatment is not uncommon when the effect is delayed. Salovum I am more restrained with because of price. I am evidence-oriented and lack a good double-blind study of Salovum.
– The effect of Salovum on cerebral edema is interesting.
Treatment stairs under constant reconstruction.
The treatment strategies «stairs» launched through the years for Menière’s disease are constantly changing in line with growing knowledge and experience.
– I must, for example, concede that Betahistidine is «ineffective». In addition, I consider injections of cortisone in the middle ear after a certain treatment time to have an effect equivalent to gentamicin injection. That a cortisone injection costs only SEK 14 is another benefit.
¬- We no longer cut off the vestibular nerve or treat the endolymphatic sack surgically. And the last time we did a total maze destruction in Lund was almost 10 years ago, Mikael Karlberg concludes
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