What is Ménière’s syndrome?
Ménière’s syndrome is a disorder of the inner ear that can affect both balance and hearing. It can occur in either ear, although it usually affects just one ear. The condition can cause severe dizziness and a feeling of spinning known as vertigo. It can also cause hearing loss, the sensation of ringing in the ears (called tinnitus), and a feeling of “fullness” in the ear.
Ménière’s syndrome is also called idiopathic endolymphatic hydrops. It is one of the more common causes of dizziness.
Who gets Ménière’s syndrome?
Anyone can get Ménière’s syndrome, but it is more common in adults between 40 and 60 years of age. Approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s syndrome and about 45,500 cases are newly diagnosed each year, according to National Institute on Deafness and Other Communication Disorders (NIDCD).
People with a family history of Ménière’s syndrome are at a higher risk of developing the syndrome.
What causes Ménière’s syndrome?
The exact cause of Ménière’s syndrome is unknown. It occurs when the pressure of fluid called endolymph becomes too high in the inner ear tubes, which are also called semicircular canals or labyrinths. These canals help your body maintain a sense of balance. Endolymph works by stimulating receptors as the body moves. The receptors send signals to the brain about the body’s position and movement. In an individual with Ménière’s syndrome, the high levels of endolymph interfere with the signals the receptors are sending to the brain. This causes the symptoms of Ménière’s syndrome. The causes of the irregularities in the fluid levels in the semicircular canals are not known.
What are the symptoms of Ménière’s syndrome?
Ménière’s syndrome often develops quickly, without any warning signs. Attacks of Ménière’s can vary in severity and can occur more than once a day, or just a few times in a year. The main symptoms include:
- A feeling of dizziness or vertigo, as if the world is spinning around you. This can be so extreme that you may not be able to stand up. The dizziness can last from a few minutes to a few hours and can cause you to feel severe nausea, vomiting, and sweating.
- A feeling of pressure or fullness in the ear. This is usually in just one ear.
- A decline in ability to hear. This may result in a “muffled” effect. The inability to hear low frequencies is usually lost first, though higher pitches may be lost eventually as well. Hearing loss can recover between attacks, but will often permanently worsen over time.
- Ringing in the ear.
Other symptoms may include:
- Abdominal pain
- Uncontrollable eye movements
You should see your doctor if you have any of these symptoms.
How is Ménière’s syndrome diagnosed?
Your doctor will begin your exam by asking questions about your attacks. He or she will ask how severe and how long each attack was and how long in total you have been having attacks. You will also be asked about any sensation of hearing loss, ear ringing, or a feeling of fullness in your ear.
After taking your medical history, the doctor may perform a series of tests to determine if you have Ménière’s syndrome. These tests may include brain MRI with contrast to rule out brain tumors or other possible causes of dizziness.
The doctor may also do a hearing test to check for any permanent hearing loss. A test called a caloric stimulation may be done to check your eye reflexes by warming or cooling the inner ear with water. Other vestibular testing may also be done to evaluate your sense of balance.
Once your doctor has the results of these tests, he or she will determine if your symptoms are caused by Ménière’s syndrome.
How is Ménière’s syndrome treated?
Ménière’s syndrome usually improves over time. It is most important to first treat the dizziness and vertigo that can be caused by Ménière’s syndrome, as these can be severe and even debilitating. Treating this major symptom can greatly improve a person’s quality of life.
Treatments for this condition include occasional anti-vertigo medications such as meclizine, diazepam, glycopyrrolate, and lorazepam. An injection of a steroid or of gentamicin (an antibiotic) directly into the ear is another treatment option.
A low-salt diet and diuretic may also be recommended to relieve fluid pressure in your inner ear.
Some patients also find that reducing caffeine, chocolate, and alcohol intake can lessen symptoms. Avoiding stressful situations and getting enough rest when possible may also help lessen the symptoms.
In unusually severe cases of Ménière’s syndrome, surgery may be recommended. Surgical options include cutting the vestibular nerve to help control vertigo, redirecting or relieving the pressure of the inner ear fluid, or directly removing the inner ear. Your doctor can recommend the best treatment plan for you.
- Johnson J, Lalwani AK. Chapter 56. Vestibular Disorders In: Lalwani AK, ed. Current Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery. 3rd ed. New York: McGraw-Hill; 2012. Accessed 7/18/2013.
- National Institute on Deafness and Other Communication Disorders. Ménière’s disease. Accessed 7/18/2013.
- American Academy of Otolaryngology — Head and Neck Surgery. Ménière’s disease. Accessed 7/18/2013.
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