Meniere’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. Meniere’s disease usually affects only one ear.
Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some people with Meniere’s disease have vertigo so extreme that they lose their balance and fall.
Meniere’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age.
The symptoms of Meniere’s disease are caused by the build-up of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and of hearing (the cochlea). It has two sections: the bony labyrinth and the membranous labyrinth. The membranous labyrinth is filled with a fluid called endolymph that, in the balance organs, stimulates receptors as the body moves. The receptors then send signals to the brain about the body’s position and movement. In the cochlea, fluid is compressed in response to sound vibrations, which stimulates sensory cells that send signals to the brain.
In Meniere’s disease, the endolymph buildup in the labyrinth interferes with the normal balance and hearing signals between the inner ear and the brain. This abnormality causes vertigo and other symptoms of Ménière’s disease.
Why do people get Meniere’s disease?
Many theories exist about what happens to cause Meniere’s disease, but no definite answers are available. Some researchers think that Meniere’s disease is the result of constrictions in blood vessels similar to those that cause migraine headaches. Others think Meniere’s disease could be a consequence of viral infections, allergies, or autoimmune reactions. Because Meniere’s disease appears to run in families, it could also be the result of genetic variations that cause abnormalities in the volume or regulation of endolymph fluid.
How does a doctor diagnose Meniere’s disease?
Meniere’s disease is most often diagnosed and treated by an ear, nose, and throat doctor, or ENT. However, there is no definitive test or single symptom that a doctor can use to make the diagnosis. Diagnosis is based upon your medical history and the presence of:
- Two or more episodes of vertigo lasting at least 20 minutes each
- Tinnitus
- Temporary hearing loss
- A feeling of fullness in the ear
How is Meniere’s disease treated?
Meniere’s disease does not have a cure, but your doctor might recommend some of the treatments below to help you cope with the condition.
Medications. The most disabling symptom of an attack of Meniere’s disease is dizziness. Prescription drugs can help relieve dizziness and shorten the attack.
Salt restriction and diuretics. Limiting dietary salt and taking diuretics (water pills) help some people control dizziness by reducing the amount of fluid the body retains, which may help lower fluid volume and pressure in the inner ear.
Other dietary and behavioural changes. Some people claim that caffeine, chocolate, and alcohol make their symptoms worse and either avoid or limit them in their diet. Not smoking also may help lessen the symptoms.
Cognitive therapy is a type of talk therapy that helps people focus on how they interpret and react to life experiences. Some people find that cognitive therapy helps them cope better with the unexpected nature of attacks and reduces their anxiety about future attacks.
Injections. Injecting an antibiotic into the middle ear helps control vertigo but significantly raises the risk of hearing loss because the medication can damage the microscopic hair cells in the inner ear that help us hear.
Surgery may be recommended when all other treatments have failed to relieve dizziness.
What is the outlook for someone with Meniere’s disease?
Scientists estimate that six out of 10 people either get better on their own or can control their vertigo with diet, drugs, or devices. However, a small group of people with Meniere’s disease will get relief only by undergoing surgery.
This fact sheet was created for public information by Deafness Forum of Australia. It is the national advocacy body for Deaf and Hearing Impaired Australians. It represents all interests and viewpoints including those people who have a chronic disorder of the ear and those who are Deafblind. www.deafnessforum.org.au