Meniere’s Disease
Meniere’s disease is a disorder that affects the inner ear. The inner ear is responsible for hearing and balance. The condition causes vertigo, the sensation of spinning. It also leads to hearing problems and a ringing sound in the ear. Meniere’s disease usually affects only one ear.
Symptoms –
Meniere’s is a progressive disease, which means it gets worse over time. It may start slowly with occasional hearing loss. Vertigo may develop later. If you’re dizzy, sit or lie down right away. Don’t do any type of movement that might make your vertigo worse. Don’t try to drive.
Along with the main symptoms, some people may have –
• Anxiety
• Blurry vision
• Nausea or diarrhea
• Trembling
• Cold sweat and rapid pulse
Attacks can last 20 minutes or 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 Meniere’s progresses, your symptoms may change. Your hearing loss and tinnitus may become constant. You might have problems with balance and vision instead of having occasional bouts of vertigo.
Causes –
The cause of Meniere’s disease isn’t known, but doctors think they understand how the symptoms of Meniere’s happen.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 Meniere’s isn’t clear.
Factors that affect the fluid, which might contribute to Meniere’s disease, include –
• Improper fluid drainage, perhaps because of a blockage or anatomic abnormality
• Abnormal immune response
• Viral infection
• Genetic predisposition
Because no single cause has been identified, it’s likely that Meniere’s disease results from a combination of factors.
Complications –
The unpredictable episodes of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Meniere’s disease. The disease can unexpectedly interrupt your life, causing fatigue and stress.
Vertigo can cause you to lose balance, increasing your risk of falls and accidents.
Diagnosis –
Healthcare providers will examine your ears and ask about hearing loss, tinnitus or a sense of fullness in one or both of your ears. They may ask if you have regular bouts of vertigo and hearing loss. If you do have those problems, they’ll ask if those bouts are severe and how long they last. They may do tests to rule out other potential conditions and confirm you have Ménière’s disease –
• Hearing test
Audiologists use audiograms to test hearing. During this test, your provider plays sounds through headphones. You’ll press a button when you hear a sound. The results measure your ability to hear.
• Vestibular test battery
Audiologists perform a series of tests to check the reflex of your inner ear (vestibular) balance system and eye muscles.
• Brain magnetic resonance imaging (MRI) with contrast
This imaging test helps to rule out potential brain tumors or other issues that may cause dizziness or hearing loss.
Treatment –
▪︎ Medications for vertigo
Doctors may recommend different types of drugs for vertigo. The options include:
• Motion sickness drugs
These medications include meclizine (Antivert) and diazepam (Valium). They can help with the spinning sensation that vertigo causes, as well as the nausea and vomiting.
• Drugs for nausea
Prochlorperazine (Compazine) is an effective medication for treating nausea during an episode of vertigo.
• Diuretics
These drugs reduce fluid retention in the body. For Ménière’s disease, doctors might prescribe a combination of triamterene and hydrochlorothiazide (Dyazide or Maxzide).
▪︎ Middle ear injections
Doctors can inject some medications into the middle ear to improve symptoms of vertigo.
These drugs include the antibiotic gentamicin (Garamycin) and steroids, such as dexamethasone (Decadron).
▪︎ Surgery
Surgery may be an option for people with Ménière’s disease if other treatments have not been effective, or if symptoms are severe. Surgical options include:
• Endolymphatic sac decompression
A surgeon removes a small portion of bone from around the endolymphatic sac. This membrane in the inner ear helps control water pressure in the ear. If it is not working correctly, this may contribute to vertigo.
• Labyrinthectomy
A surgeon removes a portion of the inner ear.
• Vestibular nerve section
A surgeon cuts the vestibular nerve.
• Vestibular rehabilitation therapy
People may experience balance problems between episodes of vertigo. A healthcare professional can instruct them on exercises and activities that may help their body and brain regain the ability to process balance.
People with hearing loss may benefit from a hearing aid.
Lifestyle Changes –
You can do several things to reduce Ménière’s disease symptoms, including –
• Follow a low-salt diet: Salty foods make you retain fluid. Excess fluid in your inner ear may trigger Ménière’s disease symptoms. Reducing the amount of salt in your diet may help reduce excess fluid.
• Consume less caffeine: Some studies indicate caffeine, particularly energy drinks, may increase vertigo attacks.
• Get help managing stress: Some research shows stress triggers Ménière’s disease symptoms.
• Try to get additional rest: Being overtired may trigger symptoms.
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