Meniere’s disease

Conditions

Meniere’s disease is a disorder that affects the inner ear which is responsible for hearing and balance. 

Ménière’s disease causes dizziness and also leads to hearing problems. Ménière’s disease usually affects only one ear.

It is more likely to occur in people in their 40s and 50s.

Ménière’s disease is chronic, but treatments and lifestyle changes can help relieve symptoms. Many people with Ménière’s disease will go into remission within a few years of being diagnosed.


The causes of Meniere’s disease

The cause of Ménière’s disease is not known, but scientists believe it is caused by changes in the fluid in the tubes of the inner ear. Other suggested causes include autoimmune diseases, allergies, and genetic mutations.


What are the symptoms of Meniere’s disease?

People with Meniere’s disease experience recurring episodes of symptoms such as dizziness, hearing loss, tinnitus (a ringing sensation in the ear), blocked or full feeling in the ear, loss of equilibrium, and headache.

Additionally, certain episodes may be accompanied by nausea, vomiting and sweating due to severe vertigo.

Generally, during episodes at least two to three of the listed symptoms will appear; however, during attack-free periods few or no symptoms may be present.

It is important to note that similar symptoms can be caused by other inner ear disorders so it is best to consult a doctor for a proper diagnosis if these symptoms are experienced.


How is Ménière’s disease diagnosed?

If you have symptoms of Meniere’s disease, your doctor will order tests to examine your balance and hearing, and rule out other causes for your symptoms.

Hearing test

A hearing test, or audiometry, is used to assess whether a person has difficulty with hearing. In this assessment, the individual wears headphones and listens to different tones of varying pitch and loudness. They are asked to indicate when they can and cannot hear a dial tone in order to identify any hearing loss.

Additionally, words will be spoken into the headset for the person to repeat so that any disparities between audio perception in each ear may be determined. Several other tests may also be performed if a problem exists in the inner ear or with the auditory nerve; these measures include electrocochleography and auditory brainstem response testing.

Balance tests

Balance tests are used to evaluate the function of the inner ear. The most common test is electronystagmography (ENG), in which electrodes are placed around the eyes and water is injected into the ear, and involuntary eye movements are tracked for abnormalities.

Rotary chair tests can also be used to detect if there is a problem in the ear or brain that may be causing balance issues.

The Vestibular Evoked Myogenic Potentials (VEMP) test assesses the sound sensitivity of the vestibule of the inner ear while posturography tests help to determine which part of the balance system isn’t working properly by challenging individuals to stand and respond safely with a harness.

Other tests

Brain diseases, such as multiple sclerosis (MS) or brain tumors, can cause symptoms similar to Ménière’s disease. Your doctor may order tests to rule out these conditions, and others. They may also order a  brain MRI  or cranial CT scan to assess possible disorders.


Meniere’s disease treatment

Ménière’s disease is a chronic, incurable disease. However, there is a range of treatments that can help relieve your symptoms, ranging from medication to surgery for the most severe cases.

Medications

There are a variety of treatments available to help manage Ménière’s disease and reduce its symptoms. Your doctor may recommend motion sickness medications to ease dizziness, nausea, and vomiting.

If fluid buildup is causing your inner ear problems, diuretics can be prescribed to help reduce the amount of fluid in your body. For more severe vertigo symptoms, a medication injection into your middle ear may be recommended as well.

Betahistine is a drug commonly used to treat Ménière’s disease. However no scientific evidence exists demonstrating its effectiveness in treating this condition. It is therefore important to reassess the efficacy of betahistine for Meniere’s disease before it continues to be prescribed.

Physiotherapy

Vestibular rehabilitation exercises can improve the symptoms of vertigo. These exercises help your brain consider the difference in balance between your two ears. A physical therapist can teach you how to perform these exercises.

Hearing aids

An audiologist can treat hearing loss, usually by fitting you with a hearing aid.

Operation

Most people with Ménière’s disease do not need surgery, but it is an option for those who have severe attacks and have not benefited from the effects of other treatments.

What is the effect of diet on Meniere’s disease?

Changing your diet can help reduce the amount of fluid in the inner ear and relieve symptoms. Foods and substances to limit or exclude from your diet include:

  • this
  • caffeine
  • chocolate
  • alcohol
  • glutamate monosodique

It’s also important to drink six to eight glasses of water a day so your body doesn’t retain fluid.

What lifestyle changes can relieve the symptoms of Ménière’s disease?

Lifestyle changes, aside from dietary changes, that may help improve your symptoms include:

  • rest during vertigo attacks
  • eat regularly, to help regulate fluids in your body
  • managing stress and anxiety through psychotherapy or medication

It is also important to quit smoking and avoid any allergens. Nicotine and allergies can make Meniere’s disease symptoms worse.

What is the outlook for people with Ménière’s disease?

Although there is no cure for Ménière’s disease, there are many strategies you may want to consider to reduce your symptoms. In most people, spontaneous remission is common, although it may take years. Your doctor can help you find a treatment that’s right for you.