What Is Meniere’s Disease?
Meniere’s disease is a disorder that affects the inner ear. The inner ear contains tubes filled with fluid called “labyrinths.” The inner ear is responsible for your balance, as well as hearing. This disorder causes vertigo (a sensation of spinning), hearing problems, and a ringing sound in the ear. Meniere’s disease usually affects only one ear.
According to John Hopkins Medicine, an estimated 615,000 people in the United States have Meniere’s disease (John Hopkins Medicine). It is most likely to occur in individuals in their forties and fifties (Mayo Clinic).
Meniere’s disease is a chronic (long-term) disease, but treatments and lifestyle changes can help to ease the symptoms. At least half of the individuals diagnosed with Meniere’s disease will go into remission within a few years after their diagnosis (University of Maryland Medical Center).
The cause of Meniere’s disease is not known, but scientists believe it is caused by changes in the fluid in the inner ear.
What Are the Symptoms of Meniere’s Disease?
Meniere’s disease symptoms tend to come on as “episodes” or “attacks.” Most individuals with Meniere’s disease do not experience symptoms between episodes.
Symptoms of Meniere’s disease include:
- vertigo (attacks can last anywhere from a few minutes to 24 hours)
- loss of hearing in the affected ear
- tinnitus (a sensation of ringing) in the affected ear
- a feeling of fullness in the affected ear
- loss of balance
- nausea, vomiting, and sweating caused by severe vertigo
Many of these symptoms can be caused by other problems in the ear. A patient with Meniere’s disease will experience at least two to three of the following symptoms at one time:
- hearing loss
- aural fullness (a feeling that the ear is full or plugged)
How Is Meniere’s Disease Diagnosed?
If you are experiencing symptoms of Meniere’s disease, your doctor will order tests to examine your balance and hearing and to rule out other causes of your symptoms.
A hearing test is used to determine if you are experiencing hearing loss. This test is also called audiometry. In this test, you will put on headphones. You will hear noises with a variety of pitches and volumes. You will need to indicate when you can and cannot hear a tone, so the technician can determine if you are experiencing hearing loss.
Your hearing will also be tested to determine if you can differentiate between similar sounds. In this portion of the test, you will hear words through the headphones. You will need to repeat what you hear. The results of this test will tell your doctor if you have a hearing problem in one or both ears.
Hearing loss can be either caused by a problem in the inner ear or by a problem with the nerve in the ear. Electrocochleography (ECog) is a test done to measure the electrical activity in the inner ear. Auditory brainstem response audiometry tests the function of the hearing nerves and the hearing center in the brain. These tests can tell your doctor if the problem is caused by your inner ear or with your ear nerve.
Balance tests are done to test the function of your inner ear. People who have Meniere’s disease will have a reduced balance response in one of their ears. The balance test most commonly used to test for Meniere’s disease is electronystagmography (ENG).
In this test, you will either have electrodes placed around your eyes to detect eye movement. This is because the balance response in the inner ear causes eye movements.
During this test, both hot and cold water will be pushed into the ear. The water causes the balance function to work. Your involuntary eye movements will be tracked. Abnormalities indicate a problem with the inner ear.
Other, less common balance tests include rotary chair testing, vestibular evoked myogenic potentials (VEMP) testing, and posturography.
Rotary chair (also called rotational chair or rotatory chair) testing will show your doctor whether your problem is caused by a problem in your ear or your brain. It is used in addition to ENG testing because the ENG results can be incorrect if there is wax blocking one of your ear’s canals or if your ear is damaged. In this test, the chair is moved while your eye movements are carefully recorded.
VEMP testing measures the sound sensitivity of the vestibule of the inner ear.
Posturography testing helps determine which part of your balance system is not functioning properly. Wearing a safety harness and standing bare feet on a platform, you will react to various balance challenges.
Issues with the brain, such as multiple sclerosis or brain tumor, can cause symptoms similar to Meniere’s disease. Your doctor may order tests to rule out other problems. Your doctor may order a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan to assess possible problems with your brain.
Medical Treatment for Menieres Disease
Your doctor may prescribe medication to help with the symptoms of Meniere’s disease. Motion sickness medicines can be used to ease symptoms of vertigo, nausea, and vomiting. If nausea and vomiting is a problem for you, your doctor may prescribe an antiemetic (anti-nausea medication).
As Meniere’s disease is thought to be caused by a problem with fluid in the inner ear, your doctor may prescribe a diuretic (a drug that causes increased urine output) to help reduce the amount of fluid. Your doctor can also inject medication into your inner ear by way of your middle ear to help reduce vertigo symptoms. Gentamicin is an antibiotic that is injected to reduce the balance in your ear, so that your other ear takes on the balancing function. Injections of steroids may also help reduce vertigo.
Rehab and Hearing Aids
Vestibular rehabilitation exercises can improve symptoms of vertigo. These exercises help to train your brain to account for the difference in balance between your two ears. These exercises can be taught by a physical therapist.
Hearing loss can be treated by an audiologist. Usually, this requires being fitted with a hearing aid.
Most people with Meniere’s disease do not require surgery, but it is an option for those who have severe attacks and have not had success with other treatment options. An endolymphatic sac procedure is done to help decrease the production of fluid and promote fluid drainage in the inner ear.
A vestibular nerve section procedure cuts the nerve that connects the ear to the brain, which reduces vertigo while preserving hearing. A labyrithecotomy is done when there is total hearing loss in the ear. This surgery removes the entire inner ear, which removes the balance and hearing function from that ear.
Self-Care and Home Treatment
Changing your diet may help to reduce the amount of fluid in the inner ear and ease symptoms. Items to limit or exclude from your diet include:
- monosodium glutamate (MSG)
It is also important to drink six to eight glasses of water per day, so your body is not retaining fluid. Other lifestyle remedies include:
- resting during vertigo attacks
- quitting smoking (nicotine can make Meniere’s disease symptoms more severe)
- eating regularly (to help regulate fluids in your body)
- avoiding allergens (allergies can make Meniere’s disease symptoms worse)
- managing anxiety and stress through psychotherapy or medication