Ménière disease is a disorder of the inner ear that affects balance and hearing. This condition is characterized by sudden episodes of extreme dizziness, a buzzing sound in the ears known as tinnitus, a feeling of pressure or fullness in the ears, and fluctuations in hearing. Episodes often are implicated with nausea and vomiting, and they can completely disrupt daily activity. The condition is named after the French physician Prosper Ménière, who in an 1861 article described the main symptoms and was the first to suggest a single disorder for all of these symptoms, in the combined organ of balance and hearing of the inner ear.
What Causes Ménière’s?
The cause of Ménière disease is still being confirmed, although it suspected to result from a combination of environmental and genetic factors. Episodes associated with Ménière disease generally last several hours. Studies suggest that episodes can be triggered by stress, tiredness (fatigue), emotional upset, illness, and dietary factors, however, the timing of these episodes are unpredictable. Many scientists believe that Ménière disease is thought to be related to abnormalities of the inner ear, which contains structures that are needed for normal hearing and balance. Episodes of vertigo, tinnitus, and hearing loss likely result from fluctuating amounts of fluid in the inner ear. These changes disrupt signals sent from the inner ear to the brain that are related to sound and the body’s position and movement.
Symptoms
Ménière disease usually appears in adulthood, most often in a person’s 40s or 50s. It is much less common in children and young adults. The symptoms of the disorder typically start in one ear, although they may later move to both ears. Attacks are as brief as 20 minutes or last 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.
Some people with Ménière disease have no symptoms of the disorder between episodes, particularly in the early stages of the disease. Over time, however, many affected individuals develop ongoing problems with unsteadiness, tinnitus, and a feeling of fullness in the ears. Additionally, permanent hearing loss eventually develops in many people with this disorder.
Treatments
Abnormal results of a caloric stimulation test of eye reflexes can indicate a sign of Meniere’s disease. An electrocochleography, MRI scan or electronystagmography (ENG) may also be recommended to decipher Meniere’s disease from other forms of vertigo. The vertigo associated with Meniere’s disease can usually be controlled with medications and dietary changes.
Medications that are effective for Meniere’s disease include:
Diuretics are the most commonly prescribed maintenance medications for Meniere’s disease. Diuretics work by restricting the overproduction of fluid in the inner ear. Diuretics are long-term medications. They help reduce the number of vertigo attacks, and in some cases, they help stabilize hearing.
Meclizine is the most commonly prescribed medication for the control of vertigo. Dramamine, available over-the-counter, is milder but might also be effective.
Valium in small doses of anti anxiety medication may be helpful when other medications fail to control the vertigo.
Low-salt Diet: Cutting back on salt will help keep the inner ear fluid low and help prevent vertigo. For most patients, 2000 mg of sodium a day is the target value. A low-salt diet consists of: not adding salt to food, avoiding prepared foods, and keeping track of your sodium intake by reading food labels.
Surgery
A few patients won’t respond to any of these treatments and will need surgery. If you’re in that minority, you have a few procedures to choose from. They include:
- Endolymphatic sac shunt surgery: The part of your ear that is responsible for reabsorbing fluid is opened and drained.
- Vestibular nerve sectioning: A neurosurgeon does this procedure, and you need a longer hospital stay, up to 5 days. The surgeon will destroy the nerve that sends signals about balance to the brain ending the vertigo.
- Cochleosacculotomy: This procedure drains fluid from the inner ear. You’re given something to numb any pain, and it takes about 30 minutes. It does put you at risk for hearing loss.
My Hearing Centers
If you suspect that you are living with Meniere’s Disease, contact us at My Hearing Centers to set up a hearing test. We can help you discover what exactly you are living with. If you are living with a hearing loss we can help you find the best treatment to help you hear better for years to come.