This topic provides information about Meniere’s Disease.
What is Meniere’s Disease?
Meniere’s Disease is a chronic disorder of the inner ear named after a Frensh physician, Prosper Meniere. You may also see it referred to as idiopathic endolymphatic hydrops. It describes a set of symptoms that occur in episodes (or attacks), including vertigo, tinnitus, fluctuating hearing loss, and a feeling or pressure of fullness in the ear. Meniere’s Disease often involves only one ear, but can extend to involve both ears over time.
What causes Meniere’s Disease?
The cause of Meniere’s Disease is not clearly known, causing some controversial beliefs. The most likely cause of Meniere’s Disease is an abnormal accumulation or fluctuation of the pressure of fluid in the inner ear, due to either excess production or inadequate absorption.
The membrane located in the inner ear is filled with a type of fluid called endoplymph. This endolymph is composed of a specific volume and chemical composition. In Meniere’s Disease, the composition of the fluid is thought to be altered by unknown factors. Some of the proposed factors influencing the composition of the emdolymph include the following:
- Head trauma
- Genetic predisposition
- Viral infection
- Abnormal absorption of fluid due to anatomic abnormality
- Autoimmune disease
Recent studies are showing that Meniere’s Disease may be a result of an immune disease, however the exact cause of the disease remains unknown.
You have a greater chance of getting Meniere’s Disease if you are between the ages of 40 to 50, but it can occur at any age.
What are the symptoms?
Attacks of vertigo, tinnitus, hearing loss, and pressure in the affected ear are the most common symptoms of Meniere’s Disease. These episodes can last for a very brief time up to several hours, with varying intensity. For some people with Meniere’s Disease, the symptoms are constant with increases and decreases in severity at times.
A typical episode of Meniere’s Disease may start with a feeling of pressure in the ear followed by an increase in tinnitus and hearing loss, followed by a severe attack of vertigo.
The hearing loss generally fluctuates and is worse during the attacks. However, Meniere’s Disease can lead to permanent hearing loss in the affected ear.
How is Meniere’s Disease diagnosed?
Diagnosis of Meniere’s Disease requires the following:
- A comprehensive history of other conditions and symptoms.
- A comprehensive hearing evaluation.
- Exclusion of other causes of the symptoms with the use of tests such as a videonystagmography (VNG), MRI or CT scan, blood tests, and/or auditory brainstem response (ABR).
- An electrocochleography (ECoG) test may also be performed. This test is sensitive to inner ear fluid pressure changes in patient’s who are symptomatic at the time of the testing.
The hearing loss seen on an audiogram is usually an intermittent hearing loss in the affected ear that is mainly affecting the low frequencies. The hearing loss will be more severe during the symptomatic attacks of the disease.
How is it treated?
There is presently no cure for Meniere’s Disease, but there are ways to manage the symptoms of the disease. These management recommendations often include a dietary restriction of salt and/or caffeine intake, use of a diuretic (water pill), and lifestyle changes such as stress reduction and regular exercise. These modifications can significantly reduce the frequency and severity of the Meniere’s episodes. Some anti-vertigo medications may also be used to reduce the dizziness symptoms. In a small minority of patients with severe symptoms who are not successful with dietary and lifestyle modifications, surgery may be needed.
Meniere’s Disease affects each person differently and your Otolaryngologist will help you to choose the treatment that is best for you.
Does Meniere’s Disease cause lasting problems?
Meniere’s Disease can be a debilitating condition when symptoms attack. Patients should work closely with their physician to find ways to reduce the symptoms of Meniere’s Disease.
The American Hearing Research Foundation (AHRF) announced recently that it has partnered with PBS for a 5-minute video, “Spotlight on Hearing and Balance”. The purpose of the video is to educate the public on Meniere’s disease. You can watch the full video below: