Ménière’s disease

Ménière’s disease

You’ve been experiencing ringing in your ears and bouts of dizziness that leave you feeling nauseous. Your hearing in one ear seems to come and go, and the ear feels “full” or even painful. If you’re experiencing a combination of these symptoms, it’s a good idea to go ahead and make an appointment with your doctor. These are signs that you may have Ménière’s Disease.

What is Ménière’s disease?

Ménière’s Disease is an inner ear condition resulting from a buildup of fluid in the inner ear. A chronic condition usually only affecting just one ear, Ménière’s Disease is characterized by a spinning sense of vertigo, hearing loss, a sense of plugging or fullness in the ear, and tinnitus. The disease is not contagious or fatal, but symptoms become progressively worse over time. The vertigo can begin to increase in severity and the risk of permanent hearing loss goes up. 

Did you know?
It usually begin with bouts of hearing loss & vertigo, giving a spinning sensation that causes dizziness

Ménière’s Disease gets its name from Prosper Ménière, a nineteenth-century French doctor who first suggested the symptoms were tied to the inner ear and not related to neurological causes.

Symptoms & causes

It's important to recognize the most common signs and symptoms of Meniere's disease. 

What are the symptoms of Ménière’s disease?

Symptoms of Ménière’s Disease usually begin with bouts of hearing loss and vertigo, which is a spinning sensation that causes dizziness. Tinnitus, or ringing sounds in the ears, is another common symptom, and people often complain of discomfort, pain, or a sense of fullness in the affected ear. 

In addition to the symptoms listed above, people with Ménière’s Disease may experience:

  • Anxiety
  • Blurry vision
  • Nausea resulting from vertigo
  • Trembling
  • Cold sweats
  • Rapid pulse

Ménière’s Disease is a progressive disease, meaning the symptoms worsen with time. Symptoms are not, however, always present. Some people get bouts of symptoms, called attacks, several times a week. Others may experience months or even years between attacks. Depending on the individual, a Ménière’s Disease attack can last from 20 minutes to 24 hours. 

Vertigo symptoms include dizziness that becomes so severe the affected person can lose their balance and fall. Such falls can, of course, lead to injury. Symptoms may change as the disease progresses, potentially causing permanent hearing loss and tinnitus. Vertigo can also cause problems with a person’s overall balance and vision. 

What causes Ménière’s disease?

Symptoms of Ménière’s Disease develop when fluid accumulates in the inner ear. The inner ear contains delicate structures necessary for hearing and maintaining a sense of balance. When fluid above the normal level builds up, it interferes with the eye's ability to function properly, resulting in both vertigo and hearing problems.  

The reason behind the fluid buildup that characterizes Ménière’s Disease is unclear. Several causes may be responsible, including inherited genetic traits and migraine headaches.

Whether one or more of these conditions is responsible for Ménière’s Disease remains a matter of debate. Some doctors believe the disease may arise from a combination of issues. And, while Ménière’s Disease can develop at any age, the condition is most commonly seen in middle-aged people. 

24h

A Ménière’s Disease attack can last from 20 minutes to 24 hours.

FAQs about Meniere's disease

How is Ménière’s disease diagnosed?

The following tests are used to diagnose Ménière’s Disease:

  • Audiometric Exams: These exams are used to evaluate the level of hearing loss in the affected ear. Testing may include a speech discrimination test, which checks your ability to tell the difference between similar sounding words (fit/sit, kite/bite, etc.).
  • Electronystagmogram tests (ENGs): ENGs are used to evaluate balance. During your test you’re placed in a dark room and your eye movements are measured and recorded. Cool and warm air is inserted in the ear canal to determine whether resulting eye movement is normal. 
  • Electrocochleography tests: These tests measure how well signals from the inner ear pass to the auditory nerve. These tests are used very rarely.

In addition, your doctor may order an MRI, a CT scan, or other imaging test to rule out conditions other than Ménière’s Disease

How is Ménière’s disease treated?

There is no cure for Ménière’s Disease. Instead, treatment focuses on reducing or eliminating symptoms. Depending on your symptoms, you may be treated with medication, hearing aids, or medical interventions. 

Medication Options

A variety of medicine is used to control Ménière’s Disease symptoms. Diuretics, or water pills, are often prescribed to reduce fluid in the inner ear by increasing the amount of liquid the body excretes. If you’re prescribed diuretics for Ménière’s Disease, your doctor may recommend that you reduce the amount of salt in your diet as well, as salt causes the body to retain water. 

Your doctor may prescribe a short course of steroids to reduce inflammation and swelling in the inner ear. People who experience nausea and vomiting during vertigo attacks may benefit from motion sickness medication. Steroids can also be injected directly into the ear.

Ménière’s Disease is sometimes treated with injections of gentamicin antibiotics that are dripped into the ear. Gentamicin is toxic to inner ear tissue, so an injection of the antibiotic reduces the affected ear’s functioning, encouraging the other ear to dominate balance. 

Hearing Aids and Meniett Devices

Hearing aids can help those with Ménière’s Disease, either by improving hearing during or after an attack. For people whose hearing fluctuates depending on attack frequency and symptom severity, today’s hearing aids are a good choice since they can be adjusted as needed. 

A Meniett device is a minimally invasive treatment of the vertigo symptoms of Ménière’s Disease.  The device, which can be used at home, applies micro pulses of pressure to the ear canal through a tube. These pulses can help normalize the pressure in the inner ear.

Surgical Treatment of Ménière’s Disease 

In some rare cases, Ménière’s Disease requires surgical intervention. Surgery is generally an option of last resort and used only in severe cases which do not respond to less invasive treatments.

Four of the most common surgical solutions include:  

Endolymphatic sac shunt surgery: The portion of the ear responsible for reabsorbing fluid is opened and drained. The procedure usually requires an overnight stay at the hospital.

Vestibular nerve sectioning: Performed by a neurosurgeon, this procedure destroys the nerve that sends balance signals to the brain, so only messages from the unaffected ear are processed. Vestibular nerve sectioning requires a hospital stay of up to five days. This solution is often a last resort treatment and is very rarely performed.

Labyrinthectomy: This procedure destroys the parts of the ear responsible for controlling balance. The surgery is performed under general anesthesia, and requires a hospital stay for a few days. Hearing loss will occur as a consequence of a labyrinthectomy, so the procedure is only recommended for people with debilitating vertigo who already have serious hearing loss in the affected ear.

Managing Ménière’s disease at home

Because Ménière’s Disease causes an accumulation of fluid in the ear, eating a low-salt diet may help manage symptoms. Reducing caffeine and alcohol intake may also help. If you experience nausea or vomiting during an attack, avoid overeating or drinking to minimize symptoms. Ménière’s Disease is similar to diabetes in that it can be managed over time, but never fully cured.

Some people report specific triggers set off their symptoms. Stress, overwork, and fatigue are commonly identified triggers. Underlying illness and sharp changes in the weather (particularly changes to air pressure) have also been reported as potential triggers. While there’s little anyone can do about the weather, controlling stress and working towards a healthy work/life balance may help reduce attack frequency or symptom severity.

What to do during a Ménière’s disease attack

During a Ménière’s Disease attack, try to lie flat on an immovable surface, such as the floor. Keep your eyes focused on an object that isn’t moving--this can help reduce dizziness. When the dizziness passes, get up slowly. 

You may feel sleepy for several hours after the attack, so try to avoid driving or operating heavy machinery. If vomiting persists for more than a day and you cannot keep liquids down, contact your doctor. 

Ménière’s Disease is not a condition you can treat without professional help. Left untreated, disease symptoms will only worsen. If you experience any of the symptoms associated with Ménière’s Disease, contact a licensed hearing care professional to discuss your concerns.

What to do if you're experiencing Ménière’s disease

If you’re experiencing symptoms that suggest Ménière’s Disease, make an appointment to discuss your symptoms with your doctor. The symptoms associated with Ménière’s Disease can indicate other conditions, and it’s important to rule out other possibilities.

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