What Is Meniere's Disease?

Ménière’s disease is an inner-ear condition that can cause vertigo, a specific type of dizziness in which you feel as though you’re spinning.

It also can cause ringing in your ear (tinnitus), hearing loss that comes and goes, and a feeling of fullness or pressure in your ear. Usually, only one ear is affected. The hearing loss eventually can be permanent.

The disorder takes its name from a French doctor, Prosper Ménière, who suggested in the 1860s that the symptoms came from the inner ear and not the brain, as most people believed.

What Causes Ménière’s?

Doctors think they understand how the symptoms of Ménière’s develop.

Fluid builds up inside a part of your inner ear called the labyrinth, which holds structures that help with hearing and balance. The extra fluid interferes with the signals your brain receives, causing vertigo and hearing problems.

Why people get Ménière’s isn’t clear. Researchers have several theories about what might affect the fluid in the inner ear, though:

  • Poor drainage (because of blockage or an abnormal structure in your ear)
  • Autoimmune response (when your body’s defense system misfires and attacks healthy cells)
  • Allergic reaction
  • Viral infection
  • Inherited tendency
  • Blow to the head
  • Migraine headaches

It’s possible that a combination of issues come together to cause Ménière’s.

Symptoms

Ménière’s is a progressive disease, meaning it grows worse over time. It may start slowly with bouts of hearing loss. Vertigo may develop later.

Along with the main symptoms, some people may have:

Attacks are as brief as 20 minutes or last as long as 24 hours. You might get several in a week, or they might come months or even years apart. Afterward, you may feel tired and need to rest.

As your Ménière’s progresses, your symptoms may change. Your hearing loss and tinnitus may become constant. You might struggle all the time with balance and vision issues instead of having occasional bouts of vertigo.

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​​​​​​​Diagnosis

You and your doctor will talk about your symptoms and medical history. A series of diagnostic tests can check your balance and hearing. These might include:

  • Audiometric exam: This will find a hearing loss in the affected ear. It might include a test to gauge your ability to tell the difference between words like “fit” and “sit.” That’s called speech discrimination.
  • Electronystagmogram: An ENG evaluates your balance. You will be placed in a darkened room and have your eye movements measured as cool and warm air blows through your ear canal.
  • Electrocochleography: This measures fluid pressure in your inner ear.
  • Additional imaging tests: An MRI or CT scan might be ordered to rule out the possibility that something other than Ménière’s has caused your symptoms.

Treatments

Drug treatment deals with reducing both your vertigo and the fluid in your ear. Medication for motion sickness might help with your vertigo, and an anti-nausea drug might reduce vomiting if that’s a side effect of your dizziness.

Other possible treatments include:

  • Diuretics: To reduce fluid in your ear, your doctor might prescribe a diuretic -- medicine that keeps your body from retaining fluids. If you take a diuretic, your doctor probably also will ask you to cut the amount of salt in your diet.
  • Steroids: If your doctor thinks you have an underlying immune system problem, you might also take a short course of steroids.
  • Therapy or hearing aid: In addition to medication, you might try therapy targeted to help with balance issues. A hearing aid could improve your affected ear.
  • Meniett device: Another approach uses this device to apply pressure to your ear canal through a tube. This improves how fluid moves through your ear. You can do these treatments at home.
  • Injections: These go straight into your ear and may ease your vertigo. Your doctors might choose an antibiotic called gentamicin (Gentak, Garamycin), which is toxic to your inner ear. It reduces the function of the affected ear so that your “good” ear takes over your balance. This procedure is done in a doctor’s office, where you’ll be given something to numb the pain before the injection. Or your doctor might choose to inject a steroid.

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Surgery

A few patients won’t respond to any of these treatments and will need surgery. If you’re in that minority, you have a few procedures to choose from. They include:

  • Endolymphatic sac shunt surgery: The part of your ear that is responsible for reabsorbing fluid is opened and drained. You’ll be given anesthesia so that you won’t be awake or feel pain during the operation. You will probably spend the night in the hospital.
  • Vestibular nerve sectioning: A neurosurgeon does this procedure, and you need a longer hospital stay, up to 5 days. The surgeon will destroy the nerve that sends signals about balance to the brain to stop the messages that are causing your vertigo.
  • Cochleosacculotomy: This is another procedure aimed at draining fluid. You’re given something to numb any pain, and it takes about 30 minutes. It can cause hearing loss, though.
  • Labyrinthectomy: Your surgeon destroys the parts of the ear that control balance. You aren’t awake during this procedure, and you stay in the hospital a few days. You will have hearing loss afterward, so it’s for people who have really bad vertigo and already don’t hear well.

What Can I Do at Home?

It’s not clear you can do anything to prevent Ménière’s disease. However, there are many things you can do the help manage your symptoms.

In addition to eating a low-salt diet, you may want to cut down on alcohol and caffeine. Some people think such diet changes lessen the effects of the disease.

Some people with Ménière’s find that certain things trigger attacks. Those might include:

  • Stress
  • Overwork
  • Fatigue
  • Sharp changes in weather, specifically air pressure
  • Underlying illness

You can take steps to identify and avoid your triggers and also to reduce stress in your life.

When to Call a Doctor

If you are dizzy, you should sit or lie down at once. Avoid any type of movement that might make your vertigo worse. Don’t try to drive.

If you think you have symptoms, call your doctor for an appointment. It is hard to predict the course of the disease, and you should not assume it will get better on its own.

WebMD Medical Reference Reviewed by William Blahd, MD on November 18, 2016

Sources

SOURCES:

Mayo Clinic: “Diseases and Conditions – Ménière’s Disease.”

Vestibular Disorders Association: “Ménière’s Disease.”

National Institute on Deafness and Other Communication Disorders: “Ménière’s Disease.”

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Understanding Autoimmune Diseases.”

American Academy of Otolaryngology – Head and Neck Surgery: “Ménière’s Disease.”

University of California San Diego Health System: “Ménière’s Disease.”

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