What is Meniere’s Disease?
Meniere’s Disease is a disorder of the inner ear. With Meniere’s Disease, patients often have symptoms that include episodes of vertigo, fullness in one or both ears, a roaring or ringing sound in one or both ears, and a sense of fullness or pressure in the ears that can last between 20 minutes to 24 hours. Vertigo is the feeling of spinning or movement when you are not moving. Vertigo is different from dizziness; dizziness can mean feeling lightheaded or feeling like you will pass out. The distinction between vertigo and dizziness (or lightheadedness) is very important, as most inner ear issues such as Meniere’s Disease cause vertigo but not dizziness.
When a patient has vertigo symptoms, and not the sound or fullness symptoms, we often term this “atypical Meniere’s Disease”.
What causes Meniere’s Disease?
The exact cause of Meniere’s Disease is not known. However, it is believed that Meniere’s Disease is caused by having too much fluid, or increased fluid pressure in one of the spaces in the inner ear.
Attacks of Meniere’s Disease often occur randomly but can follow a meal high in sodium (salt), alcohol intake, caffeine intake, nicotine use, or stressful situations.
Who Is at Risk for Meniere’s Disease?
Meniere’s Disease is seen mostly in adults aged 40 to 60 years, but a very small percentage is seen in people under 18 years of age. While there is no known genetic link, Meniere’s symptoms occasionally are seen in several family members.
How is Meniere’s Disease diagnosed?
To be diagnosed with this disease, your health care provider will ask for the history of your symptoms. Your symptoms may include having 2 or more attacks of vertigo, fluctuating hearing loss, ear pressure, and/or ringing in the ear. Because the disease is a clinical diagnosis, it can take several office visits with your health care provider to narrow down what is causing a patient’s symptoms. There are often other causes of vertigo, ear pressure, and ringing in the ear that have different treatments, so your health care provider may run different tests to find the causes of those symptoms.
Your health care provider will ask you to describe vertigo in detail and will ask questions about other ear problems (ear infections, surgeries) and other issues like headaches and migraines. Your health care provider will have to get a full history of your symptoms, which will require a lot of questions and possibly having you keep a journal to track those symptoms. A hearing test (audiogram) should be offered because changes in hearing are a part of MD that is different from other causes of vertigo. There are no x-rays, CT studies, or MRI studies that can identify Meniere’s Disease. There are several vestibular tests that can be ordered which can point to a reason for a patient’s vertigo, but none will definitively identify Meniere’s Disease.
Are all cases of Meniere’s Disease the same?
No, there is quite a bit of variation in the frequency, duration of attacks, triggering factors, and even which ear is affected. In fact, in some patients there can be stretches of decades between attacks.
Can Meniere’s Disease cause permanent injury or disability?
The vast majority of patients with this disease experience annoying outbreaks which leave no lingering imbalance, hearing loss, fullness, or tinnitus between episodes. There is a very small group of patients with Meniere’s Disease have a progressive course, with drops in hearing that can be permanent, tinnitus which can become long-term, and progressive incapacitating vertigo.
How is Meniere’s Disease treated?
There is no cure for Meniere’s Disease; however, there are several treatments to manage the symptoms. Your treatment will be a decision between you and your health care provider. Some of the ways to treat vertigo, ringing in the ear, and hearing loss, include the following:
- Changing your diet to reduce salt, alcohol, nicotine, and caffeine
- Stress reduction maneuvers
- Medications such as diuretics which help manage sodium levels in the body and the inner ear
- Less well-studied medications such as Beta-histine, and Lipoflavenoids
- Physical therapy
- Hearing aids
- Shots into the ear of steroids or strong antibiotics
- Surgeries to try to stop vertigo (may also cause deafness and ongoing generalized imbalance)
Your health care provider can talk with you about the pros and cons of each treatment option to come up with an individual treatment plan that is best for you. It may take multiple visits with your health care provider to create your treatment plan. Having an advocate (family member or friend) come with you during these discussions with your health care provider can also help you make a good treatment decision.
Where can I get more information about Meniere’s Disease?
Below are some resources that have links to support groups:
- Vestibular Disorders Association (VeDA)
- Ménière’s Resources Inc.
- Ménière’s Society
- Ménière’s Research Fund, Inc.
- Hearing Health Foundation
You can also find educational information on from the American Academy of Otolaryngology at ENT Health – Ménière’s Disease and from the National Institutes of Health – Meniere’s Disease. This information can assist you with talking with your health care provider and help you make the right decisions about your treatment.