What is Ménière’s disease?
Ménière’s disease (idiopathic endolymphatic hydrops) is a rare inner ear disorder. It affects your sense of balance and hearing. Left untreated, Ménière’s disease symptoms get worse over time and may cause permanent hearing loss and ongoing balance problems. Healthcare providers typically treat Ménière’s disease with medication that eases symptoms.
Is Ménière’s disease serious?
Ménière’s disease isn’t a life-threatening illness, but it can affect quality of life. People who have this disorder may struggle with symptoms that happen without warning, come back time and again, and may disrupt their daily lives. Here is more information about Ménière’s disease symptoms:
- Vertigo: This condition makes people feel as if the world is whirling around them even when they’re standing still. They may feel they need to sit down so they don’t fall down. Vertigo can happen without warning and be very severe. Some people with vertigo have “drop attacks” — they literally topple over and fall to the ground because vertigo upends their sense of balance.
- Ménière’s disease affects hearing, causing problems like tinnitus and temporary trouble hearing, which may escalate to hearing loss.
- Some people with Ménière’s disease develop anxiety, worrying when and how future vertigo attacks will affect them. Some people develop depression due to the symptoms that affect hearing and balance.
Is Ménière’s disease common?
No, it’s rare. According to the most recent data from National Institute on Deafness and Other Communication Disorders, about 615,000 people in the United States have the disorder. (There are more than 330 million people in the United States.)
Who is affected by this condition?
Ménière’s disease typically affects people ages 40 to 60. About 7% to 10% of people have a family history of this disorder.
Symptoms and Causes
What are the four main symptoms of Ménière’s disease?
The four main symptoms are:
- Hearing loss.
- Feeling pressure or a sense of fullness. This is usually in just one ear.
Other symptoms include:
What triggers Ménière’s disease symptoms?
Healthcare providers know Ménière’s disease symptoms happen when endolymph, a fluid in your inner ear, builds up and disrupts the delicate process your body uses to manage balance and hearing. They don’t know why endolymph levels rise.
Endolymph is like a translator. It interprets outside airwaves and sends signals that your brain and inner ear use to allow you to hear and maintain your balance. When there’s too much endolymph in your inner ear, those signals become scrambled so your brain can’t manage your sense of balance and hearing.
Some people have a family history of Ménière’s disease, which means people may inherit the condition.
Diagnosis and Tests
How do healthcare providers diagnose Ménière’s disease?
Healthcare providers will examine your ears and ask about hearing loss, tinnitus or a sense of fullness in one or both of your ears. They may ask if you have regular bouts of vertigo and hearing loss. If you do have those problems, they’ll ask if those bouts are severe and how long they last. They may do tests to rule out other potential conditions and confirm you have Ménière’s disease:
- Hearing test: Audiologists use audiograms to test hearing. During this test, your provider plays sounds through headphones. You’ll press a button when you hear a sound. The results measure your ability to hear.
- Vestibular test battery: Audiologists perform a series of tests to check the reflex of your inner ear (vestibular) balance system and eye muscles.
- Brain magnetic resonance imaging (MRI) with contrast: This imaging test helps to rule out potential brain tumors or other issues that may cause dizziness or hearing loss.
Management and Treatment
How do healthcare providers treat Ménière’s disease?
Healthcare providers may start with treatments to reduce pressure on your inner ear from high endolymph levels. They may also prescribe medications to help with vertigo, including:
- Diuretics: This medication reduces the amount of fluid in your body. Reducing fluid overall may bring down inner ear fluid levels.
- Motion sickness medications: These medications help control vertigo episodes.
- Antihistamines: This medication may reduce vertigo attacks
- Intratympanic steroid injection: A medical provider may inject steroids through your eardrum as a means of controlling episodes of Ménière’s disease.
What are other treatments?
The U.S. Food and Drug Administration (FDA) recently approved pressure pulse treatment to treat vertigo. This treatment uses a device that fits in your outer ear to “puff” air pressure on your middle ear. Air pressure on your middle ear may affect endolymph levels.
Healthcare providers may recommend cognitive therapy to help people cope with the stress, anxiety and depression Ménière’s disease may cause.
What are surgical treatments for Ménière’s disease?
If other treatments don’t reduce symptoms, healthcare providers may use surgery to treat very severe cases of Ménière’s disease. Surgical options include redirecting or relieving the pressure from the inner ear fluid, such as:
- Endolymphatic sac procedure: Your endolymphatic sac is a hollow pouch that drains inner ear fluid. In endolymphatic sac procedures, providers release fluid by cutting into the sac. They may place a stent in the sac so fluid continues to drain from the sac.
- Vestibular nerve section: Your vestibular nerve helps regulate balance and hearing. Removing the nerve helps with vertigo and reduces hearing loss.
- Labyrinthectomy: This surgery removes your labyrinth, the part of your inner ear that controls balance. Providers typically do this surgery only after you’ve lost hearing in your affected ear.
Can I reduce my risk of developing Ménière’s disease?
No, but if you have Ménière’s disease, you can reduce your risk the disease will worsen. Contact your healthcare provider if you suddenly develop dizzy spells that may be vertigo. These symptoms may indicate Ménière’s disease. Some people have family members with this disease. If that’s your situation, ask your healthcare provider about monitoring your overall health for indications you’re developing Ménière’s disease.
Outlook / Prognosis
Does Ménière’s disease go away?
Ménière’s disease may go away for months or years, but it always comes back. Healthcare providers have medication and other treatments that reduce vertigo symptoms, but Ménière’s disease is a chronic illness that never really goes away.
I have Ménière’s disease. How do I take care of myself?
You can do several things to reduce Ménière’s disease symptoms, including:
- Follow a low-salt diet: Salty foods make you retain fluid. Excess fluid in your inner ear may trigger Ménière’s disease symptoms. Reducing the amount of salt in your diet may help reduce excess fluid.
- Consume less caffeine: Some studies indicate caffeine, particularly energy drinks, may increase vertigo attacks.
- Get help managing stress: Some research shows stress triggers Ménière’s disease symptoms.
- Try to get additional rest: Being overtired may trigger symptoms.
When should I see my healthcare provider?
If you’re receiving treatment, contact your healthcare provider if your symptoms get worse
What questions should I ask my healthcare provider?
Ménière’s disease is a rare illness, which means you may have many questions about the condition. Questions you may want to ask include:
- Why do I have Ménière’s disease?
- Will my symptoms get worse?
- How do you treat this disease?
- What are treatment side effects?
A note from Cleveland Clinic
If you have Ménière’s disease, you may feel like you’re being stalked by a disease that jumps out at you when you least expect it. Ménière’s disease symptoms — vertigo attacks and hearing problems — happen without warning and can be very severe. In particular, vertigo makes you feel dizzy, disoriented and nauseated. You may feel like you can’t live a normal life because you don’t know when you’ll have another attack. You may struggle with anxiety, waiting for and worrying about the next bout. Fortunately, healthcare providers have treatments that reduce Ménière’s disease symptoms, including vertigo. They also understand how this condition may affect your mental health. If you have this disease, ask your healthcare provider about programs and services to help you cope.
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