What is Meniere's disease?
Meniere's disease is a disorder of the flow of fluids in the inner ear.
What causes Meniere's disease?
Although the cause of Meniere's disease is unknown, it probably results from an abnormality in the way fluid of the inner ear is regulated.
- In most cases, only one ear is involved, but both ears may be affected in about 15% of patients.
- Meniere's disease typically starts between the ages of 20 and 50 years of age (although it has been reported in nearly all age groups).
- Men and women are equally affected.
- The symptoms may be only a minor nuisance or can become disabling, especially if the attacks of vertigo are severe, frequent, and occur without warning.
- Meniere's disease is also called idiopathic endolymphatic hydrops.
What are the symptoms of Meniere's disease?
The symptoms of Meniere's disease typically include at least several of the following:
- Episodic rotational vertigo: Attacks of a spinning sensation accompanied by disequilibrium (an off-balanced sensation), nausea, and sometimes vomiting. This is usually the most troublesome symptom. Vertigo usually last 20 minutes to four hours or longer. During attacks, patients are very disabled, and sleepiness may follow. An off-balanced sensation may last for several days.
- Tinnitus: A roaring, buzzing, machine-like, or ringing sound in the ear. It may be episodic with an attack of vertigo or it may be constant. Usually, the tinnitus gets worse or will appear just before the onset of the vertigo.
- Hearing loss: It may be intermittent early in the onset of the disease, but over time it may become a fixed hearing loss. It may involve all frequencies, but most commonly occurs in the lower frequencies. Loud sounds may be uncomfortable and appear distorted in the affected ear.
- Ear fullness: Usually this full feeling occurs just before the onset of an attack of vertigo.
How is Meniere's disease diagnosed?
The diagnosis of Meniere's disease is primarily made from the history and physical examination. Tinnitus or ear fullness (aural fullness) needs to be present to make the diagnosis.
An audiogram is helpful to show hearing loss, and to rule out other abnormalities. It is often helpful if it can be done safely, to have an audiogram during or immediately following an attack of vertigo. This may show the characteristic low-frequency hearing loss. As the disease progresses hearing loss usually worsens.
Other tests such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography (CT scan), or magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause symptoms similar to Meniere's disease. A full neurological evaluation is performed to exclude other causes of vertigo.
How can Meniere's disease be treated?
Treatment for Meniere's disease could include the following:
- Medications: A diuretic (water pill) such as triamterene (Dyazide, Maxzide) combined with a low salt diet, is the primary treatment of Meniere's disease. Anti-vertigo medications such as meclizine (Antivert, Bonine, Meni-D, Antrizine) mask the symptoms, providing relief, or diazepam (Valium) may provide temporary relief during more severe attacks of vertigo. Anti-nausea medications [for example, promethazine (Phenergan)] sometimes also are prescribed. In some cases, steroids and certain antibiotic medications (gentamicin) injected into the middle ear may provide some relief from vertigo symptoms. Both anti-vertigo and anti-nausea medications may cause drowsiness. Because nausea can be so severe at times, medications may be prescribed in the form of a suppository
- Air pulse generator: in some patients, periodic delivery of small air pulses transmitted through a tube placed in the eardrum has had some variable success.
- Surgery: If vertigo attacks are not controlled medically and are disabling, for a minority of patients, one of the following surgical procedures may be recommended depending on the individual patient's situation:
What is the prognosis for Meniere's disease?
Although there is no real cure for Meniere's disease, the attacks of vertigo can be controlled in nearly all cases. If you have vertigo without warning, you should not drive, because failure to control the vehicle may be hazardous to yourself and others. Safety may require you to forego ladders, scaffolds, and swimming.
Top Meniere Disease Related Articles
CT Scan (Computerized Tomography)A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
Hearing LossHearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause. Sensorineural hearing loss can be caused by conditions affecting the cochlea, eighth cranial nerve, spinal cord, or brain. Examples of conditions that can lead to sensorineural hearing loss include Meniere's disease, noise-induced hearing loss, hearing loss of aging (presbycusis), nerve injury from syphilis, hearing loss of unknown cause (idiopathic hearing loss), nerve tumors, and drug toxicity (such as aspirin and aminoglycosides).
diazepamDiazepam is a drug prescribed for the treatment of anxiety disorders; and agitation, tremors, delirium, seizures, and hallucinations that result from alcohol withdrawal. Diazepam can lead to addiction (dependency), especially when higher dosages are used over prolonged periods of time. The most common side effects of diazepam are drowsiness, fatigue, diarrhea, rash, euphoria, and ataxia (loss of balance). Do not use diazepam if pregnant or breastfeeding.
Cardio Exercise: Good for More Than Your HeartYou might have guessed that cardio, or aerobic, exercise helps to strengthen your heart. But did you know it's good for your health in lots of other ways, too? Learn about the hidden benefits.
Is There Surgery for Meniere’s Disease?Meniere’s disease is a chronic condition that manifests as hearing loss, vertigo, and ringing in the ears. Various surgical options are available for refractory Meniere’s disease that does not respond to medications or if the symptoms of the disease are severe.
Inner Ear Infection (Labyrinthitis)Labyrinthitis occurs when there is inflammation of the part of the ear responsible for balance and hearing), usually due to viral infections of the inner ear. Learn about causes, symptoms, and treatment.
meclizineMeclizine is an OTC antinausea medication used to treat nausea and vomiting, and dizziness associated with motion sickness. Meclizine can cause drowsiness. Other side effects include nausea, dry mouth, blurred vision, rash, constipation, diarrhea, and urinary retention (inability or difficulty urinating). Do not take meclizine if breastfeeding. Consult your doctor if pregnant.
MRI (Magnetic Resonance Imaging Scan)MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Nausea and VomitingNausea and vomiting are symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and other illnesses. Learn about causes, treatment, and when to be concerned.
Noise-Induced Hearing Loss and Its PreventionNoise-induced hearing loss may be an acoustic trauma, which causes temporary hearing loss, or it may be permanent due to an acute acoustic trauma. Experts agree that continual exposure to more than 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
promethazinePromethazine is a drug prescribed to treat nausea, vomiting, motion sickness, allergic reactions, and for sedation prior to surgery. Promethazine causes sedation, confusion, and disorientation. In children less than two years of age it can depress respiration and lead to death. Other side effects include anticholinergic side effects such as blurred vision, dry mouth, dilated pupils, nausea, urinary retention (inability to urinate), impotence, and constipation.
Surgery for Meniere’s DiseaseMeniere’s disease is a chronic condition that manifests as hearing loss, vertigo, and ringing in the ears. Various surgical options are available for refractory Meniere’s disease that does not respond to medications or if the symptoms of the disease are severe.
Tinnitus is described as a throbbing, ringing, clicking, or buzzing in one or both ears. Tinnitus is caused by trauma to the ear, over exposure to loud noises, medication, and diseases or infections of the ear such as multiple sclerosis, TMJ, autistic neruoma, Meniere's disease, hearing loss, and aging. Treatments include medication, tinnitus masking, retraining therapy, and relief therapy.
Tinnitus SlideshowWhat is tinnitus? Explore tinnitus (ringing in the ears) causes, symptoms, relief remedies, treatments and prevention tips. Learn about pulsatile tinnitus.
What Can Trigger Vertigo?Vertigo is the sensation of spinning or rocking, even when someone is at rest. Vertigo may be caused by a problem in the brain or spinal cord or a problem within in the inner ear. Head injuries, certain medications, and female gender are associated with a higher risk of vertigo. Medical history, a physical exam, and sometimes an MRI or CT scan are required to diagnose vertigo. The treatment of vertigo may include medication, special exercises to reposition loose crystals in the inner ear, or exercises designed to help the patient re-establish a sense of equilibrium. Controlling risk factors for stroke (blood pressure, weight, cholesterol, and blood glucose) may decrease the risk of developing vertigo.