Menieres Disease

What is Meniere’s disease?

Meniere’s disease (also called idiopathic endolymphatic hydrops) is a chronic disorder of the inner ear that can affect both balance and hearing. It usually affects just one ear and can cause severe dizziness and a feeling of spinning (vertigo). This condition can also cause hearing loss, the sensation of ringing (tinnitus) and a feeling of “fullness” in the ear. Meniere’s disease is one of the most common causes of dizziness.

Who is affected by Meniere’s disease?

Meniere’s disease can affect anyone. 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 Meniere’s disease, and about 45,500 cases are diagnosed each year. In general, people with a family history of Meniere’s disease are at a higher risk of developing this condition.

What are the causes of Meniere’s disease?

The exact cause of Meniere’s disease is unknown. However, it occurs when the pressure of fluid (endolymph) becomes too high in the inner ear tubes.

The tubes help your body maintain a sense of balance. The endolymph works by stimulating receptors as the body moves. The receptors send signals to the brain about the body’s position and movement.

If you have Meniere’s disease, the high levels of endolymph interfere with the signals the receptors are sending to your brain. The causes of the irregularities of fluid levels in the tubes are unknown.

What are the symptoms of Meniere’s disease?

Meniere’s disease often develops quickly, without any warning signs. Attacks of Meniere’s can vary in severity and can occur more than once a day. Or the attacks may occur just a few times per year. The main symptoms include:

  • A feeling of dizziness as if the world is spinning around you (vertigo): This symptom can be so severe that you may not be able to stand up. The dizziness can last from a few minutes to a few hours and can cause severe nausea, vomiting, and sweating.
  • A feeling of pressure or fullness in one ear.
  • A decline in your 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 it will permanently worsen over time.
  • Ringing in the ear.

Other symptoms may include:

  • Headaches
  • Abdominal pain
  • Nausea
  • Diarrhea
  • Uncontrollable eye movements

You should see your doctor if you have any of these symptoms.

How is Meniere’s disease diagnosed?

1. Medical history

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 feeling of fullness in your ear.

2. Tests

Your doctor may perform a series of tests to determine if you have Meniere’s disease. These tests may include brain Magnetic Resonance Imaging (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 tests may also be done to evaluate your sense of balance.

Once your doctor has the test results, he or she will determine if your symptoms are caused by Meniere’s disease.

What are the treatment options for Meniere’s disease?

There is no cure for Meniere’s disease. However, the available treatment options are meant to reduce symptoms and improve the quality of life. Treating the major symptoms of dizziness and vertigo first can greatly improve your condition, as these symptoms can be severe and even debilitating.

Medications

Your doctor can prescribe medications to reduce dizziness and shorten the Meniere’s attack. Common medications include anti-vertigo drugs, such as meclizine, diazepam, glycopyrrolate, and lorazepam.

Injections

An injection with either gentamicin (an antibiotic) or corticosteroid can be injected directly into the middle ear. It may help relieve dizziness and control vertigo. But a gentamicin injection raises the risk of hearing loss significantly as gentamicin can damage the microscopic hair cells in the inner ear that help us hear.

Diet changes and diuretics
  • Adhering to a low-salt diet
  • Reducing caffeine, chocolate, and alcohol consumption
  • Taking diuretics (water pills) to relieve the fluid pressure in the inner ear
Life style (behavioral) changes
  • Avoiding stressful situations
  • Getting enough rest when possible
  • Quitting smoking
Cognitive therapy

Talk therapy may help you focus on how to interpret and react to life experiences.

Pressure pulse therapy

The U.S. Food and Drug Administration has recently approved a device for the treatment of Meniere’s disease. The device fits into the outer ear and delivers intermittent air pressure pulses to the middle ear. The pressure pulses seem to prevent dizziness by acting on endolymph.

Surgery

In rare cases of severe Meniere’s disease, surgery may be recommended. Surgical options include:

  • Cutting the vestibular nerve (cranial nerve) to help control vertigo
  • Redirecting or relieving the pressure of the inner ear fluid
  • Directly removing the inner ear

Your doctor can recommend the best treatment option(s) for you.

References:

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/24/2017…#15167